Biphasic bioceramics have been widely indicated for bone reconstruction; however, the real gain in bone mass due to the presence of such biomaterials has not been established yet nor the advantages of its association with platelet concentrate. This study aims at quantifying the volume of bone matrix, osteoblasts, osteocytes, blood vessels and adipose tissue after the application of a biphasic bioceramics composed of 65% hydroxyapatite and 35% beta-tricalcium phosphate. Critical-size bone defects were produced in rabbit femora and reconstructed with bioceramics only, with bioceramics combined with platelet concentrate, with platelet concentrate alone, and with no treatment (blood clot). The quantitative evaluation was performed on histological sections using histomorphometry. Our data provide original evidence that consolidates the indication of bioceramics for clinical bone loss reconstruction. The application of biphasic bioceramics alone led to major bone mass gain and was followed by its association with platelet concentrate. On the other hand, platelet concentrate can contribute to the augmentation and maintenance of the adipose tissue, representing a new field for future applications in plastic surgery.

Background: The restoration of facial contour is one of the pillars for the treatment of facial disharmonies and deformities. Fat transplantation and fillers have been widely used to improve the positioning of soft tissues, which are, however, directly related to the conditions and positioning of the underlying bone tissue. Recontouring of the latter has been performed using osteotomies and several types of bone grafts or biomaterials, as inlay or onlay grafts/implants. Here, biphasic calcium phosphate bioceramics were applied in a series of cases, their long-term results are shown, and their advantages, discussed. Methods: A retrospective analysis of 20 patients, who were subjected to facial recontour with onlay implants of biphasic calcium phosphate bioceramics, is reported. Patients were seeking to improve facial harmony due to congenital deformities, trauma, tumor resection or signs of aging, and were followed for up to 16 years. Clinical data, radiographic images, and information regarding pain and other findings were retrieved from medical records. Results: Six patients were men and 14 were women. Their ages ranged from 19 to 64 years. Bioceramics were implanted under the periosteum through external or intraoral incisions. Some patients underwent combined procedures, such as rhinoplasties or facial lifting. None of the patients presented exacerbated inflammation or pain. One of them had infection in the intraoral incision, which was resolved with medication. Conclusion: All patients had improved facial contours following the use of bio-ceramics to augment bone tissue and presented stable results at long-term evaluation.

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Introduction. The reconstruction of major bones defects is a challenge to orthopedics. Several procedures and several materials were and have been used in an attempt to reconstruct the damaged tissue areas. Several materials are used: autological, homological [9], heterological [11] and synthesized, metallic, polymeric, and ceramics, with specific positive and negative aspects pertaining to each one that lead to risk/benefit, cost/benefit, predictability and effectiveness analyses that have an impact on surgeons' choice of materials and procedures. Based on these analyses and scientific studies in the area [1], we started using, in 1986, a biphasic phosphocalcic micromacro porous HA-TCP bioceramic to rebuild bone defects in bone ruptures [4-6-13]. Based on our experience in hundreds of cases, we settled on the possibility of rebuilding large bones losses [8][9][10] in infected exposed fractures of long bones, having initiated work on this in 1996 [2]. The specific features and properties of this bioceramic, as well as the proven results, indicated that this was a material that was capable of allowing us to obtain predictable results in treating osteomyelitis, even of the chronic variety, in which conventional procedures call for the conversion of an infected pseudo-arthrosis, draining or non-draining, with later consolidation [3-5-7]. The purpose of this work is to present the cases of exposed fractures of long bones with bone loss, treated surgically with bioceramics, in which results have been assessed through clinical and radiological data and a critical analysis of the materials and procedures.