Cranial Reshaping Using Methyl Methacrylate

Abstract

Reconstruction of the facial skeleton and cranial vault has always posed difficult problems. To obtain a good result, various autologous, homologous, and heterologous grafts and biomaterials can be used. In this work, the authors present their experience in the use of methyl methacrylate (MMA) presenting a simple technique for application of the material that reduces the risk of complications. The authors also performed a review of the international bibliography relative to the use of MMA as an autologous bone substitute, analyzing the risks, complications, and results obtained.Between October 2003 and September 2007, the authors used MMA in procedures of cranial reshaping on 9 patients who underwent surgery to repair the damage caused by cranial-facial traumas and malformations.The technique of layered application of MMA made it possible to obtain excellent aesthetic and functional results in 8 patients, whereas in 1 case, the material had to be removed when the patient developed complications due to infection.Methyl methacrylate still remains the material of choice for cranioplasty on adult patients. The application of the material and sequenced layers makes it possible to reduce perioperative complications to the utmost, providing an excellent aesthetic and functional result.

Evaluation of Soft Tissue Coverage over Porous Polymethylmethacrylate Space Maintainers Within Nonhealing Alveolar Bone Defects

“…63 Despite these findings, a number of studies exist that report no complications with solid PMMA use in craniofacial applications. 12,35,64,65 Porous PMMA, as previously mentioned, has also been investigated in animal studies and limited clinical use. In a long-term study in guinea pigs comparing porous and solid PMMA implanted in the hypodermis, van Mullem et al reported implant extrusion occurred in 4/36 solid implants and none of the porous implants.…”

Balancing the Rates of New Bone Formation and Polymer Degradation Enhances Healing of Weight-Bearing Allograft/Polyurethane Composites in Rabbit Femoral Defects

“…Injectable bone void fillers (BVFs) include nonsetting allograft 5 and nonallogenic pastes, 6 which are typically delivered using viscous carriers (e.g., sodium hyaluronate, 7 glycerol, 8 or dextran 9 ) resulting in weak mechanical properties. Resorbable CPCs, [10][11][12][13] such as beta-tricalcium phosphate (b-TCP, slowly resorbed by osteoclasts) or calcium sulfate (CSH) and brushite (undergo dissolution), have also been used to enhance bone healing. Tri-phasic CPCs comprising CSH, brushite, and granular b-TCP have been shown to heal metaphyseal defects in preclinical 14 and clinical studies.…”

Aesthetic Occiput Augmentation Using Methylmethacrylate

“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] The primary concern is the risk of postoperative infection, which could necessitate explantation. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] The primary concern is the risk of postoperative infection, which could necessitate explantation.…”

“…Significantly and concurrently with less invasive cosmetic onlay cranioplasty using several kinds of surgical implants, 7,8 such as methylmethacrylate, [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] hydroxyapatite, [28][29][30] high-density polyethylene, [31][32][33] titanium mesh, 34 and solid silicone 35 being introduced to the public during the past 2 decades, there has been great interest in public perception of the details that comprise beauty 36 including a new focus on more aesthetically pleasing head shape. 15,35,37,38 This has led to frequent patient requests for purely aesthetic occiput augmentation, specifically in Asia, where the normal cranial shape is mesocephalic or brachycephalic, often with a planar occiput.…”