Craniofacial Bone Reconstruction with a Bioactive Fiber-Reinforced Composite Implant

Objective: A bioactive fiber-reinforced composite (FRC) is presented to address some of the problems faced in current options for craniofacial reconstruction. Design of FRC implant couples osteoconductive and antimicrobial properties of bioactive glass (BAG) with synthetic biostable. Material and Methods: Patient-specific implants were laminated at TCBC. The sandwich type of framework was fabricated from open-pore biostable glass-fiber weave with a porous layer into which bioactive component of bioactive glass granules (S53P4) were incorporated. Total 23 patients had 25 FRC reconstructions for craniomaxillofacial bone defects from 2007 to 2012. The average time of follow-up was 23 months with a range from 1 to 56. The patients were aged between 2.5 and 78 years (mean age 38.8 years). Results: Of the 23 patients, 7 (30%) had reconstruction with FRC after the primary reconstruction with other material failed and 16 (70%) had a primary reconstruction with FRC. Four patients (17.2%) had their FRC implant removed due to complication. Two of these patients had a secondary reconstruction with FRC. In total, 25 reconstructions with FRC were performed. In 21 out of 23 patients (91%) the FRC implant provided good aesthetic and functional outcomes. Conclusions: Reconstruction of difficult skull defects with the novel bioactive composite implant is a promising solution compared with available conventional materials. The FRC is compared with gold standard treatment.