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Facial implants offer hope for the injured: 2005-01-11
Implants rebuild children's faces
Scientists have developed an implant which they say could help rebuild the faces of children injured in accidents or born with facial defects.
Nottingham University scientists say early data from trials, published in Advanced Materials, is promising.
The implants are made of a flexible honeycomb-like material which can easily bond with bone.
But face surgery experts said long-term data was needed before the implants could be deemed successful.
It is too early to say if this is a significant development
Iain Hutchison, UK facial surgery expert
The implants have been developed by teams from the University of Nottingham and the Institute of Laser and Information Technology in Troitsk, near Moscow. The research was funded by the UK's Wellcome Trust.
Around 50 children have undergone surgery using the new technique, including a baby with a jaw tumour and a 12-year-old girl who was barely able to open her mouth before the operation.
Scientists initially use X-rays and commuter tomography (CT) images to create a three-dimensional plastic cast of the damaged area.
They determine how much bone needs to be removed before creating the implant to fit the space.
Once they have assessed how much bone needs to be removed, scientists "draw" an outline of the implant which is needed by a laser beam which leaves a very fine coating of polymer.
This process is repeated hundreds of times until the model is complete.
The technique, which takes just a few hours, can be used to make the most intricate shapes which are then sent to the hospital.
A mineral-like substance called hydroxyapatite is then added to the PolyHap implants.
The researchers say this makes the polymer tough and "bone-friendly".
They say the implant is also designed to be highly porous, which is important for new bone to grow.
Professor Steve Howdle, from the School of Chemistry, University of Nottingham, said: "Precision is vital in this type of operation since every injury will be unique in some way and the patient is obviously hoping for the best possible visual affect after surgery.
"We are delighted that operations using the polymer implants have gone very well, especially as the surgeons are working with children who have suffered serious injuries."
Professor Vitaly Roginsky, one of the cranio-maxillofacial surgeons who has used the implants, said : "They allow us to carry out many more operations than before.
"They are easier to adjust and reshape and give us much more flexibility in our work."
Although initial results from the trials have been good, the researchers say there is a possibility the implants might have to be replaced as the child grows and bones develop.
The next stage of their research will be to start work on a bio-degradable version of the implant which would dissolve as the repairing bone begins to regrow.
Iain Hutchison, head of the UK's first facial surgery research centre at St Bartholomew's Hospital in London, said it would be years before researchers could be confident these implants would work.
He told the BBC News website: "It is too early to say if this is a significant development. Is the implant going to stay in place, is it going to get infected, is it going to come loose."
Mr Hutchison added: "There are other people working on similar research. But it all adds to the body of knowledge on this subject."