Publications by authors named "Matti J Peltola"

5 Publications

  • Page 1 of 1

Novel composite implant in craniofacial bone reconstruction.

Eur Arch Otorhinolaryngol 2012 Feb 1;269(2):623-8. Epub 2011 Jun 1.

Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, P.O. BOX 52, 20521, Turku, Finland.

Bioactive glass (BAG) and polymethyl methacrylate (PMMA) have been used in clinical applications. Antimicrobial BAG has the ability to attach chemically to surrounding bone, but it is not possible to bend, drill or shape BAG during the operation. PMMA has advantages in terms of shaping during the operation, but it does not attach chemically to the bone and is an exothermic material. To increase the usefulness of BAG and PMMA in skull bone defect reconstructions, a new composite implant containing BAG and PMMA in craniofacial reconstructions is presented. Three patients had pre-existing large defects in the calvarial and one in the midface area. An additive manufacturing (AM) model was used preoperatively for treatment planning and custom-made implant production. The trunk of the PMMA implant was coated with BAG granules. Clinical and radiological follow-up was performed postoperatively at 1 week, and 3, 6 and 12 months, and thereafter annually up to 5 years. Computer tomography (CT) and positron emission tomography (PET-CT) were performed at 12 and 24 months postoperatively. Uneventful clinical recovery with good esthetic and functional outcome was seen. CT and PET-CT findings supported good clinical outcome. The BAG-PMMA implant seems to be a promising craniofacial reconstruction alternative. However, more clinical experience is needed.
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http://dx.doi.org/10.1007/s00405-011-1607-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259392PMC
February 2012

Long-term microscopic and tissue analytical findings for 2 frontal sinus obliteration materials.

J Oral Maxillofac Surg 2008 Aug;66(8):1699-707

Department of Otorhinolaryngology and Head and Neck Surgery, Turku University Hospital, Turku, Finland.

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http://dx.doi.org/10.1016/j.joms.2007.11.020DOI Listing
August 2008

Bioactive glass hydroxyapatite in fronto-orbital defect reconstruction.

Plast Reconstr Surg 2007 Dec;120(7):1963-1972

Turku, Finland From the Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital.

Background: Synthetic bioactive ceramics and glasses have osteoconductive properties. These materials are capable of chemically bonding to the bone tissue. In addition, special bioactive glasses do not favor microbial growth. In this study, the clinical outcome of bioactive glass and hydroxyapatite in head and neck surgery was evaluated.

Methods: In a retrospective series of 150 patients, 62 patients underwent reconstruction with frontal sinus obliteration after chronic frontal sinusitis, 65 patients were operated on for fronto-orbital traumas, and 23 patients underwent reconstruction after fronto-orbital tumor resections. These patients were evaluated for surgical procedures, reconstruction materials, complications, and functional outcomes.

Results: Three of the 62 frontal sinus occlusions underwent operation (4.8 percent) during the follow-up of 5 years. The reoperations were caused by a new mucocele. In fronto-orbital reconstructions, we have reoperated on the orbital floor in four cases (7 percent). All 12 benign tumor patients and six of 11 malignant tumor patients survived during a follow-up of 3 years. Two of the 23 (9 percent) complicated tumor and trauma patients underwent reoperation because of a local mucocele.

Conclusions: Treatment of severe head and neck defects with biomaterial is a suitable alternative to conventional methods. Bioactive materials seem to be stable and reliable at clinical follow-up. The reconstructions with bioactive glass and hydroxyapatite are associated with good functional and aesthetic results without donor-site morbidity. However, more long-term outcomes of studied biomaterials are needed to determine whether they are capable of competing with traditional tissue grafts.
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http://dx.doi.org/10.1097/01.prs.0000287319.34425.27DOI Listing
December 2007

Reconstruction of critical size calvarial bone defects in rabbits with glass-fiber-reinforced composite with bioactive glass granule coating.

J Biomed Mater Res B Appl Biomater 2008 Feb;84(2):510-9

Department of Prosthetic Dentistry and Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland.

Unlabelled: The aim of this study was to evaluate glass-fiber-reinforced composite as a bone reconstruction material in the critical size defects in rabbit calvarial bones. The bone defect healing process and inflammatory reactions were evaluated histologically at 4 and 12 weeks postoperatively. Possible neuropathological effects on brain tissue were evaluated. The release of residual monomers from the fiber-reinforced composite (FRC) was analyzed by high performance liquid chromatograph (HPLC).

Results: At 4 weeks postoperatively, fibrous connective tissue ingrowth to implant structures was seen. Healing had started as new bone formation from defect margins, as well as woven bone islets in the middle of the defect. Woven bone was also seen inside the implant. Inflammation reaction was slight. At 12 weeks, part of the new bone had matured to lamellar-type, and inflammation reaction was slight to moderate. Control defects had healed by fibrous connective tissue. Histological examinations of the brain revealed no obvious damage to brain morphology. In HPLC analysis, the release of residual 1,4-butanedioldimethacrylate and methylmethacrylate from polymerized FRC was low.

Conclusions: This FRC-implant was shown to promote the healing process of critical size calvarial bone defect in rabbits. After some modifications to the material properties, this type of implant has the potential to become an alternative for the reconstruction of bone defects in the head and neck area in the future.
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http://dx.doi.org/10.1002/jbm.b.30898DOI Listing
February 2008

Frontal sinus and skull bone defect obliteration with three synthetic bioactive materials. A comparative study.

J Biomed Mater Res B Appl Biomater 2003 Jul;66(1):364-72

Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, Finland.

Three synthetic bioactive materials were studied in an experimental model to compare their usability in a frontal sinus and a skull bone defect obliteration. Bioactive glass number 9 (BAG(1)), bioactive glass number 13 (BAG(2)), and hydroxyapatite (HA) granules were investigated. BAG(1) and HA granules have been previously tested clinically. The clinical usefulness of BAG(2) granules has not been tested. Upper bony walls of 45 Elco rabbits' frontal sinuses were drilled open from four separate holes with the use of a standard method. The skull bone defects and the sinuses in frontal bone were filled with BAG(1) or BAG(2) on one side, and with HA on the other side. Two parallel posterior defects were covered with a pedicled periosteum flap, and two anterior defects with a free flap. The resorption of materials, new bone, and fibrous-tissue formation were observed with a histomorphometric method at 1, 3, and 6 months postoperatively. Scanning-electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR) were done at 6 months. In histomorphometry, the new bone formation increased with all the investigated materials throughout the study (p < 0.001), but the results showed higher new bone formation in the defects filled with BAG(1) than in corresponding BAG(2)- or HA- filled defects. New bone formation and resorption of materials were faster in defects covered by pedicled than by free periosteum flaps (p < 0.001). Intimate contact between the used materials and new bone was confirmed by SEM. FTIR analysis of bone produced by BAG(1) and BAG(2) was of the same type as natural frontal bone. BAG(2) can be manufactured in various shapes, and thus, could possibly be used in clinical conditions requiring a special anatomical implant shape. However, more research is needed regarding this property of BAG(2).
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http://dx.doi.org/10.1002/jbm.b.10023DOI Listing
July 2003