Artificial bone hope for face operations – BBC News, 2 July 2004

Chief Executive Iain Hutchison comments on the advances of computer technology which could revolutionise facial surgery.

Doctors currently take bone from the hip if they are replacing facial bones damaged in accidents or by cancer. But an Oxford University team say early results of their substance – which uses constituents of natural bone – are promising. Other experts said finding an effective substitute for leg bone was the ‘Holy Grail’ of facial surgery.

Research teams across the world are working to try to develop a cheap and effective bone substitute.

In total, around 2.2m bone transplants are performed globally each year.

Surgeons currently have to take bone from the hip . But this means the amount that can be used is limited – and the procedure is also risky.

Bone made from man-made materials can also be used, but there is a danger the body will reject it as a foreign substance.

‘Natural healing’

The team from Oxford University, which has formed a spin-off company called Teox, have developed a “scaffold” of collagen, which is found in bone, reinforced with mineral crystals.

A Magnetic Resonance Imaging (MRI) scan is taken of the face, so doctors can see exactly what shape is needed to fill the gap in the bone, and reconstruct the face,

Once that is known, the team say the scaffold can be grown in the lab within a few days.

This can then be implanted during surgery, and the patient’s own bone will grow into and around it, in the same way that bone fractures heal naturally.

The research team say their research is at an early stage, but add that their results so are promising.

Dr Terry Sachlos, who developed the substitute as part of his PhD, told BBC News Online: “At the moment, replacing facial bone is a long process. It takes up lots of operating time, and it’s very difficult to get the best cosmetic result, because you’re effectively depending on the surgeon’s ‘carving skills’.”

“The advantage with the dry bone substitute we have developed is that it is a natural product.”

Further trials are now needed, but Dr Sachlos hopes the product will be available to surgeons within a few years.

“I think it will benefit patients psychologically tremendously, because they will be able to regain the way they looked normally.”

Ongoing search

Iain Hutchison, a consultant in oral and maxillofacial surgery at St Bartholomew’s Hospital in London, who established the first research centre into facial surgery, said many surgeons were working on developing a usable bone substitute.

“The computer technology has been ahead of surgical technique for a long time. We have had the ability to create accurate images of what we want to reconstruct.

“But people have been searching for years for a bone substitute that can be used. It’s the ‘Holy Grail’.”

[Reproduced from BBC News, 2 July 2004]