Kauke-Navarro Martin, Knoedler Leonard, Knoedler Samuel, Safi Ali Farid
Department of Surgery, Division of Plastic and Reconstructive Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, United States.
Craniologicum, Center for Craniomaxillofacial Surgery, Bern, Switzerland.
Front Surg. 2024 Jul 18;11:1409733. doi: 10.3389/fsurg.2024.1409733. eCollection 2024.
The search for an ideal bone substitute in reconstructive surgery has led to the exploration of various materials, with hydroxyapatite (HaP) emerging as a promising candidate due to its biocompatibility, osteoconductive properties, and structural similarity to human bone. Despite its potential, there is a paucity of data on the long-term safety and efficacy of HaP in facial skeletal reconstruction and augmentation.
We conducted a systematic review following PRISMA 2020 guidelines, searching PubMed/MEDLINE, Google Scholar, CENTRAL, and Web of Science databases for studies on hydroxyapatite facial implants in reconstruction and augmentation.
Our search yielded 12 studies that met our inclusion criteria, encompassing 74 patients treated with HaP implants for various indications including facial fractures/defects, aesthetic facial balancing, and after tumor resection. The studies reported on outcomes such as implant integration, complications, aesthetic results, and patient satisfaction, with a general trend indicating positive outcomes for the use of HaP in facial reconstruction.
Hydroxyapatite appears to be a viable and effective material for facial skeletal reconstruction and augmentation, offering benefits in terms of biocompatibility, osteoconductivity, and patient outcomes. However, limitations such as low mechanical strength and the need for further research on long-term safety and efficacy were identified. This review underscores the potential of HaP in craniofacial surgery while highlighting areas for future investigation.
在重建手术中寻找理想的骨替代物促使人们探索各种材料，羟基磷灰石（HaP）因其生物相容性、骨传导特性以及与人体骨骼的结构相似性而成为一种有前景的候选材料。尽管具有潜力，但关于HaP在面部骨骼重建和增大中的长期安全性和有效性的数据却很匮乏。
我们按照PRISMA 2020指南进行了系统综述，在PubMed/MEDLINE、谷歌学术、CENTRAL和科学网数据库中搜索关于羟基磷灰石面部植入物用于重建和增大的研究。
我们的搜索产生了12项符合我们纳入标准的研究，涵盖74例接受HaP植入物治疗的患者，其适应证包括面部骨折/缺损、面部美学平衡以及肿瘤切除术后。这些研究报告了诸如植入物整合、并发症、美学效果和患者满意度等结果，总体趋势表明在面部重建中使用HaP有积极结果。
羟基磷灰石似乎是用于面部骨骼重建和增大的一种可行且有效的材料，在生物相容性、骨传导性和患者预后方面具有优势。然而，也发现了诸如机械强度低以及需要对长期安全性和有效性进行进一步研究等局限性。本综述强调了HaP在颅面外科手术中的潜力，同时突出了未来研究的领域。
