L.L. Verhoef , B. Gareb , J.M.C. van Dijk , R.R.M. Bos
{"title":"Calcium phosphate vs. autologous cranioplasty in a pediatric population","authors":"L.L. Verhoef , B. Gareb , J.M.C. van Dijk , R.R.M. Bos","doi":"10.1016/j.jcms.2025.05.019","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objective</h3><div>Persistent skull defects due to trauma, tumors, or neurosurgical procedures often necessitate cranioplasty. Autologous bone flaps are the gold standard but have a high risk of complications in pediatric cases, especially bone flap resorption. This study evaluated alloplastic HA-βTCP (TricOs™) versus autologous cranioplasties, aiming to identify the ideal material for pediatric cranioplasties.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis of cranioplasties in pediatric patients with large cranial defects operated between 1995 and 2021 was conducted. Survival times of autologous and alloplastic HA-βTCP (TricOs™) cranioplasties were compared using Kaplan-Meier curves and log-rank test.</div></div><div><h3>Results</h3><div>The cohort included 22 cranioplasties (11 autologous, 11 alloplastic HA-βTCP (TricOs™)). Autologous cranioplasties demonstrated 63,6 % failure rate versus 9,1 % in the alloplastic group. Mean survival time was significantly longer for alloplastic - (67.61 ± 7.96 months (95 % CI [52.00; 83.21])) compared to autologous cranioplasties (32.75 ± 13.20 months (95 % CI [6.88; 58.61])) (p = 0.035).</div></div><div><h3>Conclusion</h3><div>Alloplastic HA-βTCP (TricOs™) demonstrated a significantly longer survival time compared to autologous cranioplasties. The findings suggest that HA-βTCP (TricOs™) offers a superior alternative in reducing risk of implant failure, potentially addressing the challenges of bone flap resorption in a pediatric population. Additional studies are warranted to endorse these retrospective findings.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 9","pages":"Pages 1481-1486"},"PeriodicalIF":2.1000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cranio-Maxillofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1010518225001842","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objective
Persistent skull defects due to trauma, tumors, or neurosurgical procedures often necessitate cranioplasty. Autologous bone flaps are the gold standard but have a high risk of complications in pediatric cases, especially bone flap resorption. This study evaluated alloplastic HA-βTCP (TricOs™) versus autologous cranioplasties, aiming to identify the ideal material for pediatric cranioplasties.
Materials and methods
A retrospective analysis of cranioplasties in pediatric patients with large cranial defects operated between 1995 and 2021 was conducted. Survival times of autologous and alloplastic HA-βTCP (TricOs™) cranioplasties were compared using Kaplan-Meier curves and log-rank test.
Results
The cohort included 22 cranioplasties (11 autologous, 11 alloplastic HA-βTCP (TricOs™)). Autologous cranioplasties demonstrated 63,6 % failure rate versus 9,1 % in the alloplastic group. Mean survival time was significantly longer for alloplastic - (67.61 ± 7.96 months (95 % CI [52.00; 83.21])) compared to autologous cranioplasties (32.75 ± 13.20 months (95 % CI [6.88; 58.61])) (p = 0.035).
Conclusion
Alloplastic HA-βTCP (TricOs™) demonstrated a significantly longer survival time compared to autologous cranioplasties. The findings suggest that HA-βTCP (TricOs™) offers a superior alternative in reducing risk of implant failure, potentially addressing the challenges of bone flap resorption in a pediatric population. Additional studies are warranted to endorse these retrospective findings.
期刊介绍:
The Journal of Cranio-Maxillofacial Surgery publishes articles covering all aspects of surgery of the head, face and jaw. Specific topics covered recently have included:
• Distraction osteogenesis
• Synthetic bone substitutes
• Fibroblast growth factors
• Fetal wound healing
• Skull base surgery
• Computer-assisted surgery
• Vascularized bone grafts