Can Midface Augmentation Be Done With Hydroxyapatite Cement?
Q: Dr. Eppley, Hello My interest is about entire midface augmentation. My wish is to avoid implants. want to try with hydroxapatite. I want to ask 3 things:1. Is it possible to use hydroxyapatite cement to augment complete midface
2. Is it possible to insert around 4 mm in thickness augmentation
3. Does it last forever or will it shrink over time. How l8ng will it stay is there any research on that
Many many thanks
A: Hydroxyapatite (HA) bone cement can be used to augment the midface as long as one understands what its coverage and augmentation limitations are. (see attached) It is a difficult material to use in the limited access than the intraoral incisions provide being an intraoperative putty that must be allowed to be placed, shaped and given time to set which requires a completely dry environment. As a result it works best in concave bone surfaces where it is more contained. A 4mm augmentation should be able to be achieved in the deepest part of the augmentation over the face of the maxilla.
Also HA is a structurally stable material that does not shrink or change structure over time. There are certain types of HA that are resorbable but when made as a bone cement they are non-resorbable.
HA cement has appealing biologic properties but it does not have the same surface areas of coverage or increases in projection that implants do.
Dr. Barry Eppley
World-Renowned Plastic Surgeon