Biomedical Engineering Reference
In-Depth Information
head during hip arthroplasty. The harvested bone material had to be processed
and stored in expensive bone banks. The allogenic bone is osteoconductive
but has only reduced osteostimulative affectivity owing to the production
process. owing to the remaining high risk of disease transmission, this method
is disregarded. In recent years, several alternative therapeutic approaches
such as synthetic bone substitutes, local growth factors and composites have
been developed.
It has been calculated from clinical data that, in the USA, the average direct
costs relating to the use of cancellous bone grafts account for approximately
US$4000 (St John
et al
., 2003). The use of synthetic materials and growth
factors is usually considered as rather expensive alternatives in comparison
with autologous bone; however, according to a study performed by lohmann
et al
. (2007), the costs of alternative methods are comparable and even
cheaper than using cancellous bone grafts for bone replacement. Furthermore,
given the complications associated with harvesting bone tissue, total costs,
especially follow-up costs, increase when using cancellous bone grafts in
comparison to bone replacement biomaterials.
Although autogenic bone grafting is associated with a considerable
complication rate and secondary morbidity (Younger and Chapman, 1989;
Arrington
et al
., 1996), it is still the gold standard for bone replacement.
Introduction of synthetic materials has opened up a wider range of available
material during the last 10 years. nonetheless, the question of an optimal
bone substitute is still unsolved.
Given the numerous complications caused by bone harvesting at the donor
site, follow-up costs play a key role in medical decision making. Thus, since
the direct costs for alternative bone materials are comparable to the costs
for autologous bone grafting, surgeons are urged to take these materials into
account for the benefit of their patients and the health care system.
1.4 Social aspects of dental and maxillofacial
conditions
oral diseases such as dental caries, periodontal disease, tooth loss,
oropharyngeal cancers and orodental trauma are major public problems
worldwide. The experience of pain, problems with eating, chewing, smiling
and communication caused by missing, discoloured or damaged teeth have
a major impact on people's daily lives and well-being. Furthermore, oral
diseases restrict activities at school, at work and at home, causing millions of
school and work hours to be lost each year throughout the world (Petersen
et
al
., 2005). Because the nature of most dental problems is not life-threatening,
but acute and normally are easily managable, their impact on well-being
is not obvious and is often minimized in the context of other more serious
chronic conditions (reisine, 1998).
