New materials for reconstructive cranio-maxillofacial s urgery and oncology
The development of artificial materials for reconstruction of tissues in maxillofacial area is topical. Materials with such useful properties as strength, extended surface, and osteoinductivity are studied. The composite material based on medical titanium alloy with original formula of coating applied by magnetron deposition with several atomic layers including calcium, phosphor and other elements extending contact surface of implant and biological tissue and hastening development of primary scar and bone tissue maturation is offered. Preclinical testings in small laboratory animals (rats) were performed to study mechanisms of biological responses to novel types of implants. In the group of nanostructured coating biological response and osteogenesis were more rapid than those for control group. The strength properties of implants studied in big laboratory animals (sheeps) were higher than for conventional material. For purposes of limited clinical protocol of public trials patients with defects of maxillofacial region after malignant tumor removal received surgical treatment. Implants including mashes, longitudinal plates and their combinations were used. The reconstruction of skull roof, zygomatoorbital complex, hard palate, body and upper ramus of mandible was performed. In all cases osteosynthesis was successful. During bone regeneration fatigue fractures specific for traditional titanium did not occur. There were no cases of early rejection of plate, it indicates similar features of hysteresis of new material with biological tissues. The offered new material for reconstructive maxillofacial surgery has several good properties, which help to solve problems of complicated defects closure in patients with head and neck cancer.