HYDROXYAPATITE IMPLANTS + Why are there barely any surgeries that utilize autogen. bone growth/bone grafting, and the ones that do exist FUCKING SUCK?

[RSzeiS]

It seems there are only two types of surgeries really: Surgery with Osteotomy or surgery that involve implanting you a piece of plastic somewhere. Bone grafts are basically NEVER used and it seems unclear as to why that is, since the technology has been around forever and gets used everywhere, from fixing complex fractures in trauma surgery or something as simple as placing a dental implant (think sinus augmentation for example).

Bone grafting - Wikipedia

en.wikipedia.org

Bone Grafts

Bone grafts are biological scaffolds and support structures. They can be autografts (patient's own bone), allografts (from a donor) or alloplastic. This article details their indications, properties and types of grafts.

www.theplasticsfella.com

Here, take a look at this: This is a thread about using bone grafting for jaw augmentation surgery:

Can H.A. Granules provide the same augmentation as implants?

Can H.A. Granules provide the same augmentation as implants?

jawsurgeryforums.com

The fact that hydroxyapatite is "converting" to bone over time, of course has major advantages as there is not a foreign implant present and therefore not the risk of the implant being the cause of problems in the future.

It has been shown that there is a 2 stage response of the body to the placement of the granular version of coralline hydroxyapatite directly on the surface of facial bone. The initial response is the ingrowth of fibrous tissue into the pores in each granule as well as between the granules. After about 2 years the persons bone grows in by a process of osteoconduction to replace the collagen. So the definitive implant is formed by the patients bone.
To place the hydroxyapatite involves surgery on the surface of the bone, to lift the bone’s membrane, and place the granules in the pocket between the bone and the periosteum. It is not injected.

According to one of the best implant surgeons in the states, HA can provide the same augmentation as implants:

"Coral hydroxyapatite if properly placed can produce the same projection as an implant. Implant placement usually requires an operation with more exposure and hence, more swelling than coral hydroxyapatite placement."

- Michael J. Yaremchuk

https://www.realself.com/question/nyc-coral-hydroxyapatite-cheekbone-augmentation

Here are some pictures, of what it would look like:

LMAO

One guy said this:

I think in theory it can, but only in certain areas. granules end up all uneven and asymetrical due to migration in places that experience alot of movement due to facial animation, and places that dont create the tight periostial scar capsule such as the jaw angles. risk goes up when your doing large augmentations. for paranasal and zygomatic augmentation it works much better. The granules are super irritating to the soft tissue as it seems to cause a lot of swelling for quite some time. I think it should be more commonly practiced. the level of osseointegration described by Bryan Mendelson (sp) in australia is holy grail worthy.

https://www.realself.com/review/melbourne-au-cheek-augmentation-chubby-droopy-face-weak-facial-bones

this is my issue exactly. face looks chubbyish because of weak bone structure. a few mm here and there with HA paste would solve my lifes woes.

This is Dr. Mendelson:


Can anyone confirm or deny any of these statements?
We had this thread last year but it really went nowhere: https://looksmax.org/threads/why-tf-are-we-not-talking-about-hydroxyapatite-implants.370246/

Thoughts?

 

[RSzeiS]

@Preston

 

[Mediterranean]

Prob because it requires a high level of skill to use and surgeons lack the financial incentive to learn how to use it due to a lack of demand. I doubt many people have heard of it. Its also very rare for a surgeon to be this into aesthetics, the average surgeon is very bluepilled

 

[noprogressno]

It seems there are only two types of surgeries really: Surgery with Osteotomy or surgery that involve implanting you a piece of plastic somewhere. Bone grafts are basically NEVER used and it seems unclear as to why that is, since the technology has been around forever and gets used everywhere, from fixing complex fractures in trauma surgery or something as simple as placing a dental implant (think sinus augmentation for example).

Bone grafting - Wikipedia

en.wikipedia.org

Bone Grafts

Bone grafts are biological scaffolds and support structures. They can be autografts (patient's own bone), allografts (from a donor) or alloplastic. This article details their indications, properties and types of grafts.

www.theplasticsfella.com

Here, take a look at this: This is a thread about using bone grafting for jaw augmentation surgery:

Can H.A. Granules provide the same augmentation as implants?

Can H.A. Granules provide the same augmentation as implants?

jawsurgeryforums.com

Here are some pictures, of what it would look like:

LMAO

One guy said this:

This is Dr. Mendelson:


Can anyone confirm or deny any of these statements?
We had this thread last year but it really went nowhere: https://looksmax.org/threads/why-tf-are-we-not-talking-about-hydroxyapatite-implants.370246/

Thoughts?

I wonder the same thing, this type of adjustment also won't have a possibility to erode bone over time like how it happens with implants sometimes. Also it is completely accepteable by body as well, only issue is they might get reabsorbed which might make the surgery pointless(this happens with hydroxiapatite sometimes afaik)
But I still think it would be superior to implants if it started to become widely used

 

[RSzeiS]

I wonder the same thing, this type of adjustment also won't have a possibility to erode bone over time like how it happens with implants sometimes. Also it is completely accepteable by body as well, only issue is they might get reabsorbed which might make the surgery pointless(this happens with hydroxiapatite sometimes afaik)
But I still think it would be superior to implants if it started to become widely used

Yes, I think it sounds overall promising. Mendelson also only has 5 star ratings on his google page. So far so good.

Rigid Hydroxyapatite bone like facial implants are finally upon us, courtesy of Italian biotech company Finceramica

https://www.finceramica.it/en/prodotti_servizi/neurochirurgia/customizedbone

looksmax.org

This guy claims there might be issues if the implant is too big?

 

[Deleted member 20631]

Someone on jawsurgeryforum claimed he got a HA implant for paranasal augmentation and one side the implant stayed/formed bone and on the other side got completely resorbed.

 

[Deleted member 20631]

I want to get a hydroxyapatite implant for better radix and browridge projection but I have to research further Into it.

The risk of infection and resorption that comes with conventional implants as well as the fact that you eventually have to get them taken out is something I’m not a fan of.

 

[RSzeiS]

Someone on jawsurgeryforum claimed he got a HA implant for paranasal augmentation and one side the implant stayed/formed bone and on the other side got completely resorbed.

hmm...

I want to get a hydroxyapatite implant for better radix and browridge projection but I have to research further Into it.

The risk of infection and resorption that comes with conventional implants as well as the fact that you eventually have to get them taken out is something I’m not a fan of.

Yup, that's about how I feel about regular implants too. But it seems (regular) HA is actually worse in that regard, compared to regular implants(?)

People made some good points in this thread.

Hydroxyapatite clarification

Hydroxyapatite clarification

jawsurgeryforums.com

Well I hate to repeat myself but here you go: Z hates hydroxyapatite because he sees too many cases that come to him with complications after infections which can be acute (where you end up in hospital) and chronic (which create a lower level constant or recurring inflammatory response in the body). I've had both types.

Second thing - when he opened me up to clear the s**t, he found the bone underneath seriously compromised (softened, fragile). He said this is not uncommon. But of course you don't see it on an x-ray, so unless you open up the person and see what's going on in there you won't know it. And you won't open the person unless you have to (as in my case). So this may be a wide-spread common side effect that is not documented and no one but few surgeons who see revision cases know about it. My second surgery (I've had 4, 3 of which big) lasted more than 6 hours, most of it to remove the s**t.

If you think my case is just bad luck, think again - he says he sees patients with complications so often that he doesn't know what quite to do with them - he ends up accepting them because there are not many others who would. I've personally heard of several cases that ended up in hospital like me after acute infections.

Mommaerts, AKA the Butcher in Brussels, also mixes the HA with blood and a clotting agent. So, there you go, the same s**t you are contemplating.

Bio-oss, and again I am repeating myself, MAY be better - I don't know for a fact that it is, but surgeons that do their homework in terms of research and practice a lot tend to prefer it, from what I've heard. Don't be naive, it's not only about the material. It's also about how it is actually processed and produced. Z told me that the patent for bio-oss is still a commercial secret so no one really knows how it is superior but practice shows it is.

The surgeon in Spain told me most surgeons abandoned HA back in the 1990s because of the frequent complications that they saw.

Why don't you contact Z? I'm sure he would talk to you if you explain your history to him.

TL;DR:

• complications after infections can be acute (hospital) or chronic (constant reoccurring inflammation)
• if complications happen, hard to remove (obviously)
• surgery might be dangerous if you have compromised, softened bone tissue, this is not uncommon apparently
• complications are generally likely
• mixing HA with blood and clotting agents = bad?

 

[ChristianChad]

Bump

 

[randomvanish]

it's a shitty alternative for real implants unfortunately.

this is not the magic potion we're looking for...

 

[RSzeiS]

Forgot to add this god-tier post

I've done a lot of research into bone grafting the past few weeks and it's way more interesting that I expected. There's a lot to them, how it's processed, where it's being applied, how big the defect is, etc. There is no perfect bone graft. PBHA is FDA approved for jaw surgery as an interpositional graft and is the most widely used material today. It has been studied over 15 years after application and the complication rate is very low. It has been used in other applications for 3 decades now and does cause problems on occasion.

Demineralized bone is just cadaver bone that's had all the minerals removed so you're left with cartilage and growth factors. The latter is what's significant since it integrates so quickly with surrounding bone taking only 6 weeks to heal vs 4mo for PBHA. That's because DBX is mildly osseoinductive. It may be resorbable, honestly I think these surgeons know less about this s**t than they think they do. Most of them don't sit around nights reading papers obsessively like we (or maybe just I) do. The guys most familiar with this stuff or those who specialize in implants and sinus lifts actually. The other reason PBHA is so popular is that it's extremely stable. HA is normally resorbable but PBHA is sintered (heated to high temperatures) which eliminates that property, resorbing only 2-5% per year. On the flip side, it's similar to cancellous bone so soft tissues grow through it more readily, which is why you rarely hear of someone losing feeling in their palate or teeth when used. Actually most of the time the graft isn't needed, as bony gaps up to 3-4mm should heal on their own and the plates provide most of the structure. b-TCP is promising but again is not new. It's resorption is much of the problem, as an interpositional graft it's not great because it resorbs too quickly. For cheekbones may be ok because incomplete augmentation only results in a small cosmetic defect. Xilloc is claiming it's their technique for shaping it that makes it better. I don't know what this "bone fluid" is that they're referring to. Bone marrow maybe?

Bio-OSS looks ok to me. Has similar issues to cadaver and DBX, foreign proteins can cause an immune reaction. I believe it's resorbable, not sure. Personally, the fewer complicated materials I have in me the better. Some surgeons say HA was abandoned because of the problems, other say because the results were terrible. Infection and rejection can happen at any time, decades later even. I know that with all these materials, once bone grows into it then it can be hard if not impossible to remove. The maxillary grafts should be easy to swap out but then all the tissue that grew through it will go with it, likes the nerves feeding the teeth and palate. Ugh.

What I was told about DBX as an interpositional graft is that the surgeon who uses it has been using it for 10-15 years and hasn't had any problems. He used to use PBHA but scoffed when I suggested it like it was old technology. He thinks HA grafts will cause problems down the line and that's why he switched. He's done like 5000 surgeries, comparable or more than most of the other big names we see here so he has the data to back up his position. I do know some of the surgeons who use PBHA have a tendency to downplay their negative results.

I've come across a bunch of other interesting materials and techniques, so many you can't possibly research them all and no way a surgeon can evaluate them. Surgeons find something that works and tend to stick with it.

Honestly, we're better off not knowing this s**t and just enjoying life lol.