Maxillofacial Plastic and Reconstructive Surgery

  • Volume 37
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  • Pages.34.1-34.14
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  • 2015
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Long-term clinical and experimental/surface analytical studies of carbon/carbon maxillofacial implants

  • Szabo, Gyorgy (Department of Oral and Maxillofacial Surgery and Dentistry, Semmelweis University) ;
  • Barabas, Jozsef (Department of Oral and Maxillofacial Surgery and Dentistry, Semmelweis University) ;
  • Bogdan, Sandor (Department of Oral and Maxillofacial Surgery and Dentistry, Semmelweis University) ;
  • Nemeth, Zsolt (Department of Oral and Maxillofacial Surgery and Dentistry, Semmelweis University) ;
  • Sebok, Bela (Department of Atomic Physics, University of Technology and Economics) ;
  • Kiss, Gabor (Department of Atomic Physics, University of Technology and Economics)
  • Received : 2015.08.26
  • Accepted : 2015.09.01
  • Published : 2015.12.31
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Abstract

Background: Over the past 30-40 years, various carbon implant materials have become more interesting, because they are well accepted by the biological environment. The traditional carbon-based polymers give rise to many complications. The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon). The aim of this study is to present the long-term clinical results of carbon/carbon implants, and the results of the scanning electron microscope and energy dispersive spectrometer investigation of an implant retrieved from the human body after 8 years. Methods: Mandibular reconstruction (8-10 years ago) was performed with pure (99.99 %) carbon implants in 16 patients (10 malignant tumours, 4 large cystic lesions and 2 augmentative processes). The long-term effect of the human body on the carbon/carbon implant was investigated by comparing the structure, the surface morphology and the composition of an implant retrieved after 8 years to a sterilized, but not implanted one. Results: Of the 16 patients, the implants had to be removed earlier in 5 patients because of the defect that arose on the oral mucosa above the carbon plates. During the long-term follow-up, plate fracture, loosening of the screws, infection or inflammations around the carbon/carbon implants were not observed. The thickness of the carbon fibres constituting the implants did not change during the 8-year period, the surface of the implant retrieved was covered with a thin surface layer not present on the unimplanted implant. The composition of this layer is identical to the composition of the underlying carbon fibres. Residual soft tissue penetrating the bulk material between the carbon fibre bunches was found on the retrieved implant indicating the importance of the surface morphology in tissue growth and adhering implants. Conclusions: The surface morphology and the structure were not changed after 8 years. The two main components of the implant retrieved from the human body are still carbon and oxygen, but the amount of oxygen is 3-4 times higher than on the surface of the reference implant, which can be attributed to the oxidative effect of the human body, consequently in the integration and biocompatibility of the implant. The clinical conclusion is that if the soft part cover is appropriate, the carbon implants are cosmetically and functionally more suitable than titanium plates.

Keywords

References

  1. Scholz MS, Blanchfield JP, Bloom LD, Coburn BH, Elkington M, Fuller JD, Gilbert ME, Muflahi SA, Pernice MF, Rae SI, Trevarthen JA, White SC, Weaver PM, Bond IP (2011) The use of composite materials in modern orthopaedic medicine and prosthetic devices: a review. Compos Sci Technol 71:1791-1803 https://doi.org/10.1016/j.compscitech.2011.08.017
  2. Adams D, Williams DF (1984) The response of bone to carbon-carbon composites. Biomaterials 5:59-64 https://doi.org/10.1016/0142-9612(84)90001-2
  3. More N, Baquey C, Barthe X, Rouais F, Rivel J, Trinquecoste M, Marchand A (1988) Biocompatibility of carbon-carbon materials: in vivo study of their erosion using carbon labelled samples. Biomaterials 9:328-334 https://doi.org/10.1016/0142-9612(88)90028-2
  4. Pesakova V, Klezl Z, Balik K, Adam M (2000) Biomechanical and biological properties of the implant material carbon-carbon composite covered with pyrolytic carbon. J Mater Sci Mater Med 11:793-798 https://doi.org/10.1023/A:1008953529111
  5. Szabo G, Barabas J, Nemeth ZS (2006) Long-term comparison of CarBulat TM (pure carbon) and titanium mandibular reconstruction plates. In: Raspall G, Lagunas GJ XVIII (eds) Congress of the European Association for Cranio-Maxillofacial Surgery. Medimond, International Proceedings, Barcelona, pp 141-5
  6. Lee SW, Szabo G, Choi JB, Choi JY, Kim SG (2014) Carbona plate shows even distribution of stress, decreases srew loosening, and increases recovery of preoperative daily feed intake amount in a rabbit model of madibular continuity defects. J Craniomaxillofac Surg 42:245-251 https://doi.org/10.1016/j.jcms.2013.05.009
  7. Golecki I (1997) Rapid vapor-phase densification of refractory composites. Mater Sci Eng R 20:37-124 https://doi.org/10.1016/S0927-796X(97)00003-X
  8. Jenkins DHR, Forster IW, McKibbin RZA (1977) Induction of tendon ligament formation by carbon implants. J Bone Joint Surg 59:53-57
  9. Blazewicz M (2001) Carbon materials in the treatment of soft and hard tissue injuiries. Eur Cell Mater 2:21-29
  10. Stary V, Bacakova L, Hornik J, Chmelik V (2003) Bio-compatibility of the surface layer of pyrolytic graphite. Thin Solid Films 433:191-198 https://doi.org/10.1016/S0040-6090(03)00309-2
  11. Grabinski C, Hussain S, Lafdi K, Braydich-Stolle L, Schalger J (2007) Effect of particle dimension on biocompatibility of carbon nanomaterials. Carbon 45:2828-2835 https://doi.org/10.1016/j.carbon.2007.08.039
  12. Rajzer I, Menaszek E, Bacakova L, Rom M, Blazewicz M (2010) In vitro and in vivo studies on biocompatibility of carbon fibres. J Mater Sci Mater Med 21:2611-2622 https://doi.org/10.1007/s10856-010-4108-3
  13. Blazewicz S, Chlopek J, Litak A, Wajler C, Staszkow E (1997) Experimental study of mechanical properties of composite carbon screw. Biomaterials 18:437-439 https://doi.org/10.1016/S0142-9612(96)00067-1
  14. Cieslik T, Szczurek Z, Chlopek J (1999) Composite carbon elements in treatment of fractures of the mandible. Acta Bioeng Biomech 1:77-80
  15. Straube GI (2001) Carbon implants in the maxillo-facial surgery. Stomatologia 27:14-21
  16. Saringer W, Nobauer-Hulmann I, Knosp E (2002) Cranioplasty with individual carbon fibre reinforced polymere (CFRP) medical grade implants based on CAD/CAM technique. Acta Neurochir 144:1193-1203 https://doi.org/10.1007/s00701-002-0995-5
  17. Offele D, Harbeck M, Dobberstein RC, von Wurmb-Schwark N, Ritz-Timme S (2007) Soft tissue removal by maceration and feeding of Dermestes sp.: impact or morphological and biomolecular analyses of dental tissues in forensic medicine. Int J Legal Med 121:341-348 https://doi.org/10.1007/s00414-006-0116-8
  18. Kanaya K, Okayama S (1972) Penetration and energy-loss theory of electrons in solid targets. J Phys D Appl Phys 5:43-58 https://doi.org/10.1088/0022-3727/5/1/308
  19. Kieswetter K, Schwartz Z, Dean DD, Doyan BD (1996) The role of implant surface characteristics in the healing of bone. Crit Rev Oral Biol Med 7:329-345 https://doi.org/10.1177/10454411960070040301
  20. Cao N, Wang QX, Dong JW, Hao GZ, Li MS (2010) Characterization and biological behaviour of carbon fiber/carbon composite scaffold with a porous surface for bone tissue reconstruction. New Carbon Mater 25:232-236 https://doi.org/10.1016/S1872-5805(09)60027-5

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