Poly Bone Nuro Spine Cranio-Facial Bone defect

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Poly. Bone Nuro. Spine

Cranio-Facial Bone defect n * Trauma * Surgically induced * Cranio-facial bone tumor n Awesome to patients & surgeons due to cosmetic problems Esp) pterional approach (bone defect & delayed temporal m. atrophy)

PMMA(acryl cement, Resin) * Most commonly used in Cranio-Facial defect area. * Advantages 1. Low Price 2. High Mechanical Strength * Disadvantages 1. May Marked Inflammation Response 2. Fibrous Encapsulation of Implant -> Possibility of Infection & loosening of implant

PMMA(acryl cement, Resin) * Disadvantages 3. High temperature (1100 C) generated -> Tissue damage 4. Shaping of Contour of implant after hardening is difficult 5. Never convert to Bone 6. No Bone bonding effect -> Need fixation device (wire, craniofix etc. )

Calcium Phosphate Cement n Advantages: - Biocompatible material - Have bone conduction activity - Easily handling - Good osteointegration - Converted to Bone n Disadvantages: - Low tensile strength than PMMA - Higher cost

Poly. Bone * Brushite Calcium phosphate Cement(CPC) -> Convert to bone is fast than other CPC * Included Poly-phosphates (Poly-P) : patent -> Poly-P have bone induction activity -> So, Poly. Bone have both bone induction & conduction activity

Poly. Bone * Bone. Source hardening time: 10 -20 mins Poly. Bone hardening time : within 5 mins * Good Bone bonding effect -> No need of fixation device such as wire or craniofix etc .

Poly. Bone * Easily making contour during application & after hardening - such as knife, or sharp instrument * Augumentation during the procedure is possible (esp. temporal area)

Tips n If dura was slack down below the inner cortex of bone margin at the bone defect area, put the gelform on the dura at the bone defect area. -> not to compress the brain by Poly. Bone

Tips n If you anticipated of delayed temporal muscle atrophy, Augmentation of temporal bone area with CPC is possible.

Tips n n It is recommended to use each 5 g package separated. Well adhesion of new CPC to already hardening CPC.

Application of Poly. Bone on Craniofacial part n Reconstruction of cranial defects -> If larger defect than 10 cm 2, use of wire mesh is recommended. n Closure of frontal sinus opening n Fronto-temporal contouring (Aneurysm Op. )

Clinical Application on craniofacial area of Poly. Bone

Clinical Application n Fronto-orbito-zygomatic approach n Onlay grafting for augmentation & smoothing contours of skeletal irregularities n MVD Op.

Clinical Application n Augumentaion of nasoglabellar, supraorbital rim, mandible n Lateral skull base reconstruction n Translabyrinthine approaches & other skull base approach

Clinical Application n All of these are non-stress-bearing areas in craniofacial skeleton

Contraindications of Poly. Bone n n n n Infected field Areas surrounding nonviable bone Abnormal calcium metabolism Metabolic bone diseases Recent untreated infection Poor wound healing Immunologic abnormalities