Development of a bioactive implant for repair and potential healing of cranial defects

Author:

Engstrand Thomas1,Kihlström Lars2,Neovius Erik1,Skogh Ann-Charlott Docherty1,Lundgren T. Kalle1,Jacobsson Hans3,Bohlin Jan4,Åberg Jonas5,Engqvist Håkan5

Affiliation:

1. Stockholm Craniofacial Centre, Department of Molecular Medicine and Surgery, Plastic Surgery Section;

2. Department of Clinical Neuroscience, Neurosurgical Section;

3. Department of Radiology and Nuclear Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm; and

4. Department of Chemistry, Polymer Chemistry Section, and

5. Department of Engineering Sciences, Applied Materials Science Section, Uppsala University, Uppsala, Sweden

Abstract

The repair of complex craniofacial bone defects is challenging and a successful result is dependent on the size of the defect, quality of the soft tissue covering the defect, and choice of reconstruction method. The objective of this study was to develop a bioactive cranial implant that could provide a permanent reconstructive solution to the patient by stimulating bone healing of the defect. In this paper the authors report on the feasibility and clinical results of using such a newly developed device for the repair of a large traumatic and therapy-resistant cranial bone defect. The patient had undergone numerous attempts at repair, in which established methods had been tried without success. A mosaic-designed device was manufactured and implanted, comprising interconnected ceramic tiles with a defined calcium phosphate composition. The clinical outcome 30 months after surgery revealed a restored cranial vault without postoperative complications. Computed tomography demonstrated signs of bone ingrowth. Examination with combined 18F-fluoride PET and CT provided further evidence of bone healing of the cranial defect.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

Genetics,Animal Science and Zoology

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