The Fate of Porous Hydroxyapatite Granules Used in Facial Skeletal Augmentation

Abstract

Facial appearance is largely determined by the morphology of the underlying skeleton. Hydroxyapatite is one of several materials available to enhance projection of the facial skeleton. This study evaluated the long-term maintenance of augmented bony projection when porous hydroxyapatite granules are used on the facial skeleton. Ten female patients aged 28–58 years were studied following aesthetic augmentation of the facial skeleton at 24 sites using porous hydroxyapatite granules. Postoperative CT scans at 3 months served as the baseline measurement and compared with scans taken at 1 and 2 years, with the thickness of the hydroxyapatite measured in axial and coronal planes. Thickness of original bone plus overlay of hydroxyapatite, thickness of the overlying soft tissue, and the overall projection (bone plus soft tissue) were recorded. It was found that 99.7% of the hydroxyapatite was maintained at 2 years, with no statistical difference (t test) from the baseline measurement. The overall projection (bony and soft tissue) was maintained as there was no evidence of native bone resorption or soft tissue atrophy. Radiographic results confirmed that the use of porous hydroxyapatite granules for enhancement of the facial skeleton is not only a predictable procedure, but maintains full bony projection at 2 years.

The hydroxyapatite Turkish Delight: a technical note

“…The manufacturer (Biomet) currently states that ProOsteon degrades after approximately 6 months [10]. However, there are no conclusive data regarding the long-term replacement of large graft volumes [11]. For craniofacial purposes, it is advantageous to use a material that undergoes little or no degradation.…”

“…Within 4 months, the resorption rate was 24–63% in bone but was not statistically significant in either intramuscular or subcutaneous tissues [13]. Furthermore, radiographic results of esthetic augmentation of the facial skeleton using porous hydroxyapatite granules in 10 female patients demonstrated that full bony projections (99.7%) were maintained after 2 years [11]. Such studies support our belief that the modified Turkish Delight method using hydroxyapatite granules is a reliable technique for nasal dorsum augmentation.…”

Application of Calcium Phosphate Materials in Dentistry

“…It has excellent biocompatibility and is able to promote osteoconduction and osseointegration. As a result of excellent favorable osteoconductive and bioactive properties, it is widely preferred as the biomaterial of choice in both dentistry and orthopedics [30–32]. …”

“…They have been developed and studied in purpose to improve the mechanical properties of porous hydroxyapatite, or vice versa, to develop partially biodegradable artificial bone grafts for tissue engineering [32, 51]. …”

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“…HAP has exceptional biocompatibility and bioactivity properties with respect to bone cells and tissues. As a result of excellent favorable osteoconductive and bioactive properties, it is widely preferred as the biomaterial of choice in both dentistry and orthopaedics 50,51 . The hydroxyapatite has a few favorable bioactive and osteoconductive properties which help in rapid bone formation, with a strong biological fixation to bony tissues.…”