The efficacy of bioceramics for the closure of burr-holes in craniotomy: case studies on 14 patients.

Purpose: Bioceramics are currently in use to cover bone defects in orthopedics and craniofacial surgery. But their compatibility and efficacy in cranium were not investigated in detail. The aims of this study were to produce, characterize, and assess the biocompatibility and osteointegration of Si-HA, Si-Sr-HA, HA-Wollastonite, and HA-Wollastonite-Frit bioceramics.

Methods: Bioceramics were implanted into the burr holes of 14 craniotomy patients who were followed up from three to 24 months. Radiologic and scintigraphic examinations were performed.

Results: Osteoblastic activity quantified by scintigraphy increased from 6.865 to 22.991±1.682 from four to eight months in the HA-Woll group. Adding fritt into HA-Woll decreased osteoblastic activity at 10 months. Si-Sr-HA displayed significantly higher osteoblastic activity when compared to the craniotomy site at 12 months. The scintigraphic ratio of the bioceramic implanted regions to the craniotomy sites varied between 1.10 and 1.57. Osteoblast formation and establishment of the trabecular pattern of bone was observed in the surroundings of bioceramics in two patients.

Conclusion: These bioceramics can be safely used to cover the burr holes of craniotomy patients, as well as to close the cranial bone defects.