**4. References**


be more opportune to wait 1 year to avoid the recidivism risk.8 Furthermore, the treatment in the hyperbaric room is effective in the bone life, with higher success percents.8,9 Another fundamental aspect is the epithesis stability,which depends frommany circumstances such as hygienic condition, material quality, and the correctmethod of the epithesis production;when these conditions are respected, the epithesis can resist for 2 years. The application of an epithesis happens with no invasive and immediate results, both fromthe aesthetic and psychologic point of views, allowing to get around with the heavy social insertion problems derived from his facial deformation. The therapeutic iter in the reconstructive treatment with epithesis foresees a dynamic study with few fundamental

Beyond the application of bone implants, several retentionmethods are possible: anatomic, exploiting the premade cavity getting to the deficit (ocular epithesis), andmechanical, exploiting outside anchorage strengths (sight glasses) and adhesive, by glue.10 Thanks to the use of the bone implants, it has been able to get around the problems caused by the use of adhesives like decoloration, the precocious deterioration of the epithesis, and inflammatory phenomena of the skin in contact with epithesis' materials. Under the point of view of the aesthetic result, the margins of an epithesis can be easily hidden, and the prosthesis ismore stable, is easy to wear, and keeps under a hygienic point of view. Furthermore, the psychologic appearance should not be neglected because, unlike traditional prosthesis, the epithesis fixed with implants are not considered as an extraneous object, with the consequent improvement of a good quality of life. At present, our experience teaches us that the indication to the position of epithesis as the first choice of treatment is when the conventional reconstructive interventions turn out to be inapplicable

Bulbulian AH. Maxillofacial prosthetics: evolution and practical application in patient

Fini Hatzikiriakos G. Uno sguardo al passato, curiosita` sulle protesi nasali. Il Valsala

Tjellstrom A. Osteointegrated implants for replacement of absent or defective ears. Clin

Tjellstrom A, Granstrom G. One stage procedure to establish osteointegration: a zero to five

Schaaf NG. Maxillofacial prosthetics and the head and neck cancer patients. Cancer

Labbe´ D, Be´nateau H, Compe`re JF, et al. Implants extra-oraux: indications et contre-

rehabilitation. J Prosthet Dent 1965; 15:554Y569

years follow-up report. J Laryngol Otol 1995;109:593Y598

indications. Rev Stomatol Chir Maxillofac 2001;102:239Y242

stages:

surgical planning;

templating;

or ineffective

**4. References** 

1985;61:61Y64

1984;54:2682Y2690

Plast Surg 1990;17:355Y366

positioning of the fixtures;

 preparation of the epithesis; fixtures; and epithesis exposure.

clinical, radiologic, and psychologic evaluation;


**3** 

Leif Hermansson

*Doxa AB Sweden* 

**Nanostructural Chemically Bonded** 

Biomaterials are based on a broad range of materials, such as organic polymers, metals and ceramics including both sintered and chemically bonded ceramics (silicates, aluminates, sulphates and phophates). The biomaterials can be made prior to use in the body in a conventional preparation of the material. The need for in situ in vivo formed implant materials makes the chemically bonded ceramics especially potential as biomaterials. These ceramics include room/body temperature formed biomaterials with excellent biocompatibility. Ca-aluminate as a biomaterial has been evaluated for over two decades with regard to general physical, mechanical and biocompatible properties. The Caaluminate based materials exhibit due to their unique curing/hardening characteristics and related microstructure a great potential within the biomaterial field. The presentation in this chapter aims at giving an overview of the use of Ca-aluminate (CA) as a biomaterial within odontology, orthopaedics and as a carrier material for drug delivery. The examination deals with aspects such as; the chemical composition selected, inert filler particles used, early properties during preparation and handling (working, setting, injection time, translucency, radio-opacity), and final long-term properties such as dimensional stability and mechanical properties (fracture toughness, compressive and flexural strength, hardness and Young´s modulus). One specific topic deals with the sealing of the Ca-aluminate biomaterials to

tissue - a key in the understanding of the mechanisms of nanostructural integration.

The Ca-aluminate bioceramics belong to the chemically bonded ceramics, which are usually presented or known as inorganic cements (Mangabhai, 1990). Three different cement systems – Calcium phosphates (CP), Calcium aluminates (CA) and Calcium silicates (CS) are discussed in some details in this section. Ceramic biomaterials are often based on phosphate-containing solubable glasses, and various calcium phosphate salts (Hench, 1998). These salts can be made to cure *in vivo* and are attractive as replacements for the natural calcium phosphates of mineralised tissues. The Ca-phosphate products are gaining ground in orthopaedics as resorbable bone substitutes. Biocements are often based on various calcium phosphate salts – sometimes in combination with Ca-sulphates (Nilsson, 2003). These salts can be made to cure *in vivo* and are attractive as replacements for the natural

**2. Overview of properties of chemically bonded ceramics** 

**1. Introduction** 

**Ca-Aluminate Based Bioceramics** 

Biomaterial Implantation in Facial Esthetic Diseases: Ultrasonography Monitor Follow-Up Elena Indrizzi, MDS, Luca Maria Moricca, MD, Valentina Pellacchia, MD, Alessandra Leonardi, MD, Sara Buonaccorsi, MD, Giuseppina Fini, MDS, PhD. The Journal of Craniofacial Surgery –Vol.19, N. 4 -July 2008
