Carbulat Plate Removal and Iliac Bone Reconstruction

28.29M

Category:

medicine

Long-term Result of Various Maxillofacial Reconstruction Methods

1. 1. dia

2. 2. dia

2012. November
The Ukraine
Long-term Result of Various
Maxillofacial Reconstruction
Methods
Autogenous Bone vs. Alloplastic Materials
G. Szabó
Semmelweis University
Budapest, Hungary

3. 3. dia

Many techniques have
been employed through
the years to reconstruct
the mandible

4. 4. dia

Reconstruction of
mandibular defects
a, Maintenance of bone integrity
b, Alloplastic material
c, Conventional bone graft
d, Living bone graft
e, Distraction osteogenesis

5. 5. dia

6. 6. dia

7. 7. dia

Implants for
mandibular
reconstruction

8. 8. dia

The past

9. 9. dia

10. 10. dia

Vitalium implants

11. 11. dia

12. 12. dia

Various reconstruction plates

13. 13. dia

14. 14. dia

15. 15. dia

Osteosarcoma

16. 16. dia

17. 17. dia

18. 18. dia

19. 19. dia

20. 20. dia

21. 21. dia

22. 22. dia

One year later free bone transplantation

23. 23. dia

Five years later

24. 24. dia

Melanoma metastasis in the central mandible

25. 25. dia

26. 26. dia

Two weeks postop.

27. 27. dia

Today

28. 28. dia

Living bone graft
Osteo-musculo-cutaneous
TOMC (trapezius)
PMOMC (pectoral)
LdOMC (latissimus)
Pedicled or free flaps
Revascularized free transplant
Iliac bone
OM/OMC
Scapula
OM
Metatarsus
OM
Radialis
OMFC
Fibula
OM/OMC

29. 29. dia

Schwannoma

30. 30. dia

Iliac bone graft

31. 31. dia

32. 32. dia

33. 33. dia

3 years later dental implants in the
transplanted bone.

34. 34. dia

Before reconstruction

35. 35. dia

Revascularised iliac bone graft.

36. 36. dia

37. 37. dia

2 years later dental implants

38. 38. dia

39. 39. dia

40. 40. dia

41. 41. dia

42. 42. dia

43. 43. dia

44. 44. dia

45. 45. dia

46. 46. dia

47. 47. dia

5 years later

48. 48. dia

Computer Generated
Titanium Cranioplasty

49. 49. dia

50. 50. dia

-Polytrauma 1991
(Only neurosugical treatment)
-From 1991-1998
-10 various operations on the craniomaxillofacial region

51. 51. dia

52. 52. dia

53. 53. dia

54. 54. dia

55. 55. dia

56. 56. dia

The future
Carbon / Carbon
prosthesis?

57. 57. dia

Carbon implants
Carbon fibres
and
Polymer matrix
Carbon fibres
and
Pyrocarbon matrix
( ~~ 50% Carbon)
Orthopedic and
Cardiac surgery
(99.99% Carbon)
Carbon / Carbon
since 20 years
New!

58. 58. dia

Carbomedics (Centerpulse)
Carbon fibres are mixed with other synthetic materials

59. 59. dia

Various devices of CarBulat™
implants

60. 60. dia

Gingival tumor with mandibular
involvement (post irrad.)

61. 61. dia

62. 62. dia

63. 63. dia

64. 64. dia

65. 65. dia

66. 66. dia

Synovial sarcoma

67. 67. dia

68. 68. dia

69. 69. dia

70. 70. dia

One week postop.

71. 71. dia

Postop. irradiation

72. 72. dia

5 years later

73. 73. dia

Ewing sarcoma in the mandible
after cytostatic treatment

74. 74. dia

Resection and Carbon-Carbon reconstruction

75. 75. dia

2 weeks postop.

76. 76. dia

10 years later

77. Carbulat Plate Removal and Iliac Bone Reconstruction

78. 78. dia

79. 79. dia

80. 80. dia

End result

81. 81. dia

Mandibular defect titanium plates fractured

82. 82. dia

Angulus
Mentum
Missing bone

83. 83. dia

CarBulat plate reconstruction

84. 84. dia

85. 85. dia

Postop. Picture
good functional
and cosmetic
result

86. 86. dia

CarBulat reconstruction
after hemimandibulectomy

87. 87. dia

Augmentation with CarBulat
Hemifacial microsomia

88. 88. dia

Wax-model and CarBulat plate

89. 89. dia

Previous rib transplantation

90. 90. dia

91. 91. dia

Investigation of the effect
of the human organism
on the structure and
morphology of the
CarBulat implant
Energy Dispersive Spectroscopy, EDS
Scanning Electron Microscope, SEM

92. 92. dia

The removed CarBulat plate after 10 years of
function

93. 93. dia

The original structure
of the CarBulat plate
and after 10 years
function.
Practically no change.

94. 94. dia

Structure of the
CarBulat plate.
Larger magnification
(1600 carbon fibres in
1 mm)

95. DISTRACTION OSTEOGENESIS

96. THE HISTORY OF DISTRACTION OSTEOGENESIS

Hippocrates

97. 97. dia

Gavril Abramovics Ilizarov
Kurgan

98. BONE HEALING

Fracture healing:
-impact (fracture)
-induction
-inflammation
-soft callus
-hard callus
-remodeling (1-1.5 years)
Fracture healig interrupted by distraction:
-osteotomy
-induction (osteotomy)
-inflammation
-soft callus
-distraction
-hard callus
-remodeling