A Decade of Experience with Injectable Poly-L-Lactic Acid: A Focus on Safety

Bartus, Cynthia; Hanke, C. William; Daro-Kaftan, Elizabeth

doi:10.1111/dsu.12128

Cited by 52 publications

(46 citation statements)

References 32 publications

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“…Polylactic acid is a biodegrad-able and biocompatible thermoplastic with widespread applications in both medical and nonmedical fields. 26,30 It has been used for implantation in the human body for functions ranging from soft tissue fillers 5,52 to fracture fixing screws.…”

Section: Discussionmentioning

confidence: 99%

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

Tan¹,

Ling²,

Dinesh³

2016

JNS

104

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T he reconstruction of a skull vault defect, termed cranioplasty, has a rich and fascinating history. For at least 5 millennia, surgeons have patched cranial defects with an immensely diverse range of materials ranging from fruit shells to sheep scapulae and man-made plastics. 42 Even today, the pursuit of the perfect cranioplasty material and technique continues.Skull defects are often the direct result of surgical decompressive craniectomy performed for acute neurosurgical emergencies. 23 The use of a patient's original bone flap for cranioplasty is theoretically sound and avoids the problems related to the use of bone from other sources, such as human cadavers (allografts) or animals (xenografts), or the use of synthetic materials. In practice, however, cranioplasty using these bone flaps, which have been stored for a period of time either in a surgically created subcutaneous pocket or in a medical freezer, is plagued with a not insignificant risk of infections and bony resorption. 8,11,22 With unnatural storage, the nature and content of these bone flaps are changed permanently, hindering successful reincorporation as part of the skull vault. Loss of osteogenesis probably plays a role; studies on human calvarial bone flaps have shown a diminution of osteoblasts after both subcutaneous 44 The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer eddie t. w. tan, mrcsed, Ji min ling, mrcsed, and shree Kumar dinesh, FrcsDepartment of Neurosurgery, National Neuroscience Institute, Singapore obJective Commercially available, preformed patient-specific cranioplasty implants are anatomically accurate but costly. Acrylic bone cement is a commonly used alternative. However, the manual shaping of the bone cement is difficult and may not lead to a satisfactory implant in some cases. The object of this study was to determine the feasibility of fabricating molds using a commercial low-cost 3D printer for the purpose of producing patient-specific acrylic cranioplasty implants. methods Using data from a high-resolution brain CT scan of a patient with a calvarial defect posthemicraniectomy, a skull phantom and a mold were generated with computer software and fabricated with the 3D printer using the fused deposition modeling method. The mold was used as a template to shape the acrylic implant, which was formed via a polymerization reaction. The resulting implant was fitted to the skull phantom and the cranial index of symmetry was determined. results The skull phantom and mold were successfully fabricated with the 3D printer. The application of acrylic bone cement to the mold was simple and straightforward. The resulting implant did not require further adjustment or drilling prior to being fitted to the skull phantom. The cranial index of symmetry was 96.2% (the cranial index of symmetry is 100% for a perfectly symmetrical skull). coNclusioNs This study showed that it is feasible to produce patient-specific acrylic cranioplasty implants with a low-cost 3D printer. Further studies...

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Section: Discussionmentioning

confidence: 99%

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

Tan¹,

Ling²,

Dinesh³

2016

JNS

104

View full text Add to dashboard Cite

show abstract

“…[42] Once injected, the material creates immediate volumization secondary to the properties associated with the product's microparticles. [43,44] However, the volumization effect disappears within a few months as the microparticles degrade and the material is metabolized, resulting in dermal fibroplasia. [43] This degradation results in the formation of connective tissue or neocollagenesis.…”

Section: Poly-l-lactic Acidmentioning

confidence: 99%

“…[43,44] However, the volumization effect disappears within a few months as the microparticles degrade and the material is metabolized, resulting in dermal fibroplasia. [43] This degradation results in the formation of connective tissue or neocollagenesis. [43,45] It is important to understand that PLA is a bio-stimulatory agent which benefits from the host system.…”

Section: Poly-l-lactic Acidmentioning

confidence: 99%

“…[43] This degradation results in the formation of connective tissue or neocollagenesis. [43,45] It is important to understand that PLA is a bio-stimulatory agent which benefits from the host system. [46] The results associated with this product therefore are not immediate and are instead gradual, lasting for at least 2 years.…”

Section: Poly-l-lactic Acidmentioning

confidence: 99%

“…The injection technique is of crucial importance given the risk of papule and nodule formation. [43,45,48] This product is overall very advantageous because it provides volume restoration while simultaneously increasing the dermal thickness. [45,47] Other advantages include reduced safety concerns because it provides temporary results, and its very good risk-benefit profile in both HIV+ and cosmetic patients.…”

Section: Poly-l-lactic Acidmentioning

confidence: 99%

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Intradermal fillers for minimally invasive treatment of facial aging

Lin¹,

Shah²,

Dhinakar³

et al. 2016

PAR

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The ever-increasing interest in retaining a youthful physical appearance has facilitated the development of various minimally invasive dermatological techniques. The use of intradermal fillers can be incorporated into dermatological practices with minimal overhead costs. This strategy addresses facial volume loss and dynamic lines, which are the main features of facial aging. Moreover, intradermal fillers provide an array of flexible treatment options for a balanced and holistic result to dermatological practitioners. This paper reviews the different intradermal fillers categorized by biodegradable and non-permanent fillers including collagen based materials, hyaluronic acid and autologous fat, semi-permanent fillers including poly methyl methacrylate, poly-L-lactic acid and calcium hydroxyapatite microspheres, and permanent fillers including silicone. A discussion is provided of the commercial products made of these materials and their clinical efficacy in the treatment of facial aging. Key words:Intradermal fillers; facial aging; volumization; biodegradable and non-permanent fillers; semipermanent fillers; permanent fillers Xin Zhao is an associate professor at Xi'an Jiaotong University, China. Prior to starting this appointment, she was a postdoctoral fellow at Medical School and School of Engineering and Applied Sciences at Harvard University. Her research involves engineering the micro-and nanoscale systems for tissue regeneration and drug delivery.

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Assessment of a Novel Computer Algorithm for Printing a 3-Dimensional Nasal Prosthetic

Shikara

Rizzi

Zelip

et al. 2018

JAMA Otolaryngol Head Neck Surg

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A Decade of Experience with Injectable Poly-L-Lactic Acid: A Focus on Safety

Abstract: Important lessons have been learned that have enhanced the safety and efficacy of injectable PLLA and have made it a desirable product for restoring facial volume.

Cited by 52 publications

References 32 publications

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

The feasibility of producing patient-specific acrylic cranioplasty implants with a low-cost 3D printer

Intradermal fillers for minimally invasive treatment of facial aging

Assessment of a Novel Computer Algorithm for Printing a 3-Dimensional Nasal Prosthetic

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