Bioceramic porous hydroxy-apatite prosthesis have been demonstrated as a valid alternative to traditional cranioplasty techniques both aesthetically and in terms of absence of infections/rejections. Principal limitations for the use of HA prostheses are the need for stereolithography process, the poor malleability of the material and the high cost.
These collected and analyzed data demonstrate that porous HA is a suitable material to produce custom-made prostheses to repair craniolacunia. It is a biomimetic implant well-tolerated in both adult and pediatric patients and has been shown to be an effective and good alternative for cranial reconstruction.
These results confirm that porous hydroxyapatite scaffolds, uniquely possessing chemico-physical and morphological/mechanical properties very close to those of bone, can be considered as a tool to provide effective bone regeneration in large cranial bone defects. Moreover, they may potentially prevent most of the postsurgical drawbacks related to the use of metal or plastic implants.
The failure rate of CustomBone Service under 7 years of age was higher than reported in adults and children over 7 years old (20.8 vs. 3.8 %), However, CustomBone Service may be considered a valid option under 7 years old since other materials are burdened by more significant rates of complications in the long-term period. Due to specific properties of this material, indication to CustomBone Service in toddlers should be carefully evaluated by the surgeon on a case-by-case basis.
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