caa a22 4500 606215603 CHVBK 20210128101059.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00701-015-2363-2 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2363-2 Paediatric cranial defect reconstruction using bioactive fibre-reinforced composite implant: early outcomes [Elektronische Daten] [Jaakko Piitulainen, Jussi Posti, Kalle Aitasalo, Ville Vuorinen, Pekka Vallittu, Willy Serlo] Background: In children, approximately half of cryopreserved allograft bone flaps fail due to infection and resorption. Synthetic materials offer a solution for allograft bone flap resorption. Fibre-reinforced composite with a bioactive glass particulate filling is a new synthetic material for bone reconstruction. Bioactive glass is capable of chemically bonding with bone and is osteoinductive, osteoconductive and bacteriostatic. Fibre-reinforced composite allows for fabricating thin (0.8mm) margins for implant, which are designed as onlays on the existing bone. Bioactive glass is dissolved over time, whereas the fibre-reinforced composite serves as a biostable part of the implant, and these have been tested in preclinical and adult clinical trials. In this study, we tested the safety and other required properties of this composite material in large skull bone reconstruction with children. Method: Eight cranioplasties were performed on seven patients, aged 2.5-16years and having large (>16cm2) skull bone defects. The implant used in this study was a patient-specific, glass-fibre-reinforced composite, which contained a bioactive glass particulate compound, S53P4. Results: During follow-up (average 35.1months), one minor complication was observed and three patients needed revision surgery. Two surgical site infections were observed. After treatment of complications, a good functional and cosmetic outcome was observed in all patients. The implants had an onlay design and fitted the defect well. In clinical and imaging examinations, the implants were in the original position with no signs of implant migration, degradation or mechanical breakage. Conclusions: Here, we found that early cranioplasty outcomes with the fibre-reinforced composite implant were promising. However, a longer follow-up time and a larger group of patients are needed to draw firmer conclusions regarding the long-term benefits of the proposed novel biomaterial and implant design. The glass-fibre-reinforced composite implant incorporated by particles of bioactive glass may offer an original, non-metallic and bioactive alternative for reconstruction of large skull bone defects in a paediatric population. Springer-Verlag Wien, 2015 Cranioplasty nationallicence Craniectomy nationallicence Craniofacial bone reconstruction nationallicence Fibre-reinforced composite nationallicence FRC nationallicence Bioactive glass nationallicence Paediatric nationallicence Skull bone defect nationallicence Piitulainen Jaakko Division of Surgery and Cancer Diseases, Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, PO Box 52, 20521, Turku, Finland aut Posti Jussi Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland aut Aitasalo Kalle Division of Surgery and Cancer Diseases, Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, PO Box 52, 20521, Turku, Finland aut Vuorinen Ville Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland aut Vallittu Pekka Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland aut Serlo Willy Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland aut Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 681-687 0001-6268 157:4<681 2015 157 701 https://doi.org/10.1007/s00701-015-2363-2 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2363-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Piitulainen Jaakko Division of Surgery and Cancer Diseases, Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, PO Box 52, 20521, Turku, Finland aut NATIONALLICENCE 700 1- Posti Jussi Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland aut NATIONALLICENCE 700 1- Aitasalo Kalle Division of Surgery and Cancer Diseases, Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, PO Box 52, 20521, Turku, Finland aut NATIONALLICENCE 700 1- Vuorinen Ville Division of Clinical Neurosciences, Department of Neurosurgery, Turku University Hospital, Turku, Finland aut NATIONALLICENCE 700 1- Vallittu Pekka Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland aut NATIONALLICENCE 700 1- Serlo Willy Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/4(2015-04-01), 681-687 0001-6268 157:4<681 2015 157 701