Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts...
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Transcript of Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts...
![Page 1: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/1.jpg)
Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant
Maurice MommaertsPresident European Association for Cranio-Maxillo-Facial Surgery
Bruges, Belgium
7th Asian Pacific Craniofacial conference, Taipeh, Taiwan
![Page 2: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/2.jpg)
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LOGO Issues
Contour irregularities in corrective osteotomies In chin osteotomy In sagittal split osteotomy for mandibular advancement in
skinny ladies
Post trauma & congenital defects Orbital region Temporal areas Localized midfacial deficiency in clefts and craniofacial
syndromes
Residual asymmetries uncorrectable with osteotomies Mandibular border & lateral surface
![Page 3: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/3.jpg)
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LOGO 2003-2008 caseload of 48 patients
14
15
3
6
4
6
0 5 10 15 20
Chin
Jaw angle
Mandibular border
BSSO defect
Paranasalaugmentation
Orbital/temporalregion
![Page 4: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/4.jpg)
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LOGO Combination
Hydroxyapatite
Pro Osteon(Interpore Cross)
Fibrin glue
Tisseel/Tissucol
Bone paste Bone paste
Human Human cancellouscancellousbonebone
Pro OsteonPro OsteonImplant Implant 500500
Blood clotBlood clot
Tisseel clotTisseel clot
![Page 5: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/5.jpg)
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LOGO Sealant
Purified fibrinogen (a protein)Purified thrombin (an enzyme)
derived from human bloodHuman blood factor XIIIAprotinin, derived from cows' lungs
Factor XIII strengthens blood clots by forming cross-links between strands of fibrinAprotinin is a protein that inhibits the enzymes that break down blood clots
Fibrin sealant (FS) Fibrin sealant (FS)
![Page 6: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/6.jpg)
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LOGO Sealant
HemostasisSealingClosing effect
As of 2003, all fibrin sealants used are made from blood plasma taken from carefully screened donors and rigorously tested to eliminate hepatitis viruses, HIV-1, and parvovirus.
Fibrin sealant (FS) Fibrin sealant (FS)
![Page 7: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/7.jpg)
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LOGO Calcium hydroxylapatite
A mineralNaturally occurring form of calcium apatite Ca5(PO4)3(OH
70% of bone is made up of HA
Ability to integrate in bone structures &support bone ingrowth, without breaking down or dissolving (i.e it is bioactive)
Granules (HA) Granules (HA)
![Page 8: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/8.jpg)
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LOGO Application mode 1
![Page 9: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/9.jpg)
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LOGO Application mode 2
![Page 10: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/10.jpg)
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LOGO Chin osteotomy - anterior
text2
anterior step anterior step
![Page 11: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/11.jpg)
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LOGO
1 day postop
![Page 12: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/12.jpg)
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LOGO Chin osteotomy - lateral
lateral step lateral step
+ autologous bone from chin ostectomy
![Page 13: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/13.jpg)
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LOGO
½ y after correction of open bite and heavy chin
![Page 14: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/14.jpg)
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LOGO
½ y after correction of open bite and heavy chin
![Page 15: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/15.jpg)
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LOGO
½ y after correction of open bite and heavy chin
![Page 16: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/16.jpg)
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LOGO
![Page 17: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/17.jpg)
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LOGO Mandibular angle in asymmetries
![Page 18: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/18.jpg)
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LOGO
![Page 19: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/19.jpg)
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LOGO Mandibular angle in drag king
![Page 20: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/20.jpg)
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LOGO
3 years postop
![Page 21: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/21.jpg)
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LOGO
![Page 22: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/22.jpg)
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LOGO In facial makeover
![Page 23: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/23.jpg)
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LOGO Infraorbital augmentation
![Page 24: Facial contour corrections with calcium hydroxyapatite granules and fibrin sealant Maurice Mommaerts President European Association for Cranio-Maxillo-Facial.](https://reader033.fdocuments.us/reader033/viewer/2022061503/551b996a550346167e8b568b/html5/thumbnails/24.jpg)
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LOGO Conclusion
“clay” “clay”
no infections no infections
rare tract extrusion rare tract extrusion
long-term results long-term results