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General Category => Aesthetics => Topic started by: Lestat on December 15, 2016, 03:05:48 AM

Title: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 03:05:48 AM
The product:
http://www.xilloc.com/ct-bone/

Update:

The company Xilloc is having problems getting the production of the implants ready. Apparently they need additional machinery and set up cleanroom production. As of today they don't have the economical means to sort it out, so they're planning for a crowfounding campaign in hopes of being able to launch CT-BONE. Their chief operation officer fears it will take a bit longer then 2016. Price range for CT-BONE implants are still estimated between 4,000-8,000 EUR.
Title: Re: What is the current state of Xilloc CT Bone?
Post by: Lestat on December 15, 2016, 03:08:08 AM
I've asked Dr. Sinn to send the CT Bone people a note requesting info about the availability of the implants and he has done so. I'm skeptical they'll be available anytime soon but if they will be we will definitely know from Dr. Sinn.
Title: Re: What is the current state of Xilloc CT Bone?
Post by: Lestat on December 15, 2016, 03:10:27 AM
Ive tried contacting CT-bone's parent company now multiple times and never received a response.

And a lot of what theyve published recently makes them look incompetent/inexperienced (having trouble getting set up). It is probably good policy to manage our expectations re: ct-bone. None the less, 3d printing is still a powerful tool if it can manufacture materials as accurately as it is claimed to be.
Title: Re: What is the current state of Xilloc CT Bone?
Post by: Lestat on December 15, 2016, 03:41:17 AM
I agree, we should manage our expectations. But it will be worth seeing what the hell this CT Bone stuff even is and what tests have been done. Can you link us to any of the scientific papers about it?

Clinical studies have been performed in Japan.

The longest follow-up period is 3 years. The material for CT-Bone was developed in Japan and they have started clinical trials 3 years ago, so unfortunately there is no data yet about longer periods.
 
They send me a flyer with an example of 3y follow-up on a chin implant.

I will upload it this evening.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 15, 2016, 03:56:05 AM
Thank you for this information.

Would it not be possible to contact a company who make custom implants and ask them to use a specific material like HA if you provide them with it?
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 03:58:18 AM
And here it is:


[attachment deleted by admin]
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 04:16:24 AM
Dr. Barry Eppley's opinion regarding CT Bone:
http://www.eppleyplasticsurgery.com/custom-skull-implant-2

Dr. Eppley is totally wrong!
CT-Bone is not yet released, so he can’t be familiar with it. The real application is augmentation, not inlay, the costs are yet even unknown to the company.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 04:19:26 AM
Thank you for this information.

Would it not be possible to contact a company who make custom implants and ask them to use a specific material like HA if you provide them with it?

Thats a good question! Sorry but I dont know. Does anyone else know?
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: boyo on December 15, 2016, 04:42:07 AM
I did receive this video from Xilloc and i've posted it before, but it may be worth rewatching for anyone interested in CT-Bone.

http://tinypic.com/player.php?v=nq7csh&s=9#.WFKO71xD5PY
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 04:48:28 AM
I did receive this video from Xilloc and i've posted it before, but it may be worth rewatching for anyone interested in CT-Bone.

http://tinypic.com/player.php?v=nq7csh&s=9#.WFKO71xD5PY

Thanks! Let's post everything regarding CT Bone in this thread. :P
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 04:56:30 AM
Sinn very recently told me in his opinion they are not 100% replaced by bone. I will talk more about this over pm when I have time

Come on Greyandblue! Please keep as updated if any news arise. 8)
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 15, 2016, 07:47:14 AM
Hi Folks so I'm sorry to be the harbinger of potentially bad news, but better to be clear and realistic.

I found this recent study on the web about the CT BONE it implied the following as I've written and I sent Erik Boelin the head of the company my analysis of this paper and my misgivings about their product. He has not responded to me with any corrections or tell me I'm wrong. I don't think I am as my assessment is from info given in that study which is from 2016. I highly doubt anything new has resurfaced with the product. If what I've surmised is true, this is not  an acceptable product for me.

I'm fairly concerned after reading this study. It suggests several things:

1) CT Bone can still lead to infections, something that wouldn't happen with
real bone.

2) CT Bone can lead to resorption of underlying bone, which wouldn't
happen with real bone.

3) If CT Bone is damaged you need a regrafting, again something that wouldn't
happen with real live bone since it would just heal on its own.

4) CT Bone doesn't "turn" into the patients own bone there is just some slight
evidence of bony union here.

And this lab test is from 2016. So the technology just isn't there and teh claims you're
implying about your product are misleading it seems to me.

http://www.sciencedirect.com/science/article/pii/S235232041630013X
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: ppsk on December 15, 2016, 08:17:20 AM
Lazlo

infection is possible with ANY surgery, even if you were to use your own bone as a graft. I don't think thats a realistic standard to hold against them, as it is a problem inherent with surgery itself.

The other points seem right. Ive always thought a lot of this was a marketing hype job, as the core substance has been around forever, the only new thing they are bringing to the table is 3d printing which allows for far more precise fits/manufacture and control of the porosity.

The major claim they need to prove is that it turns in, and integrates with real bone. If they cannot demonstrate this, then really its just a better version of medpor
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 15, 2016, 08:21:16 AM
Well listen I would be somewhat remiss if I didn't point out that there was a 25 percent risk of infection with this new CT Bone. Check it out 4 out of 20 patients.

Also they clearly claim right here there isn't sufficient bone remodelling by claiming the following in their conclusion. It's a hype job. Best to stay with your own bone bros.

Conclusions

The CT-bone showed maintenance of the original shape and good bone replacement, based on the middle- and long-term follow-ups. In the future, we would make an intelligent type of artificial bones in which bone regeneration is induced by gradually releasing angiogenesis-inducing factors and/or bone-regeneration-inducing factors at the three-dimensionally controlled positions.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: ppsk on December 15, 2016, 08:23:54 AM
a major point of concern in the literature:
"In one case (Case 3), there was an accident in which a handle of an umbrella significantly hit the mental region due to a strong wind at 1 month postoperatively, causing damage to the CT-bone engrafted in the region. For this reason, the patient underwent re-graft of a CT-bone under local anesthesia at 1 month postoperatively with no subsequent problem. "

Remember what one of the big plastic surgeons said when asked about this potential new development?

He said something to the effect of he suspects the material would be incredibly brittle. Sounds like he was right. I mean how possibly hard do you think an umbrella handle hits you in the face from strong winds?
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 15, 2016, 08:24:07 AM
If anything Xilloc should partner with this company whose 3D printed bone has at the very least the virtue of being like unbreakable which would be awesome. You could get hit in the face with a bat and your bone would still hold shape.

This is the frontier of meta-human engineering my friends.

But as the site says, human testing is 5 years away.

http://www.theverge.com/2016/9/28/13094642/hyperelastic-bone-graft-substance-unveiled

I'm gonna stick with chin wings and ZSO's and modified lefort 3 's till then.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 09:13:32 AM
Those are really bad news Lazlo! :(

I knew that Xilloc has done a big investment that has enabled them to do all manufacturing in-house. They have already installed their 3D printers.
So the problem were not the printers, it is the product - the calciumphosphate for real bone-replacing implants.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 15, 2016, 09:22:16 AM
Those are really bad news Lazlo! :(

I knew that Xilloc has done a big investment that has enabled them to do all manufacturing in-house. They have already installed their 3D printers.
So the problem were not the printers, it is the product - the calciumphosphate for real bone-replacing implants.

Yes, here's my problem with these implants. As you guys know I broke my cheekbone in an assault and I asked Dr. Sinn what should be done. He said "nothing" the fracture will heal on itself and the bone is not too displaced.

Let's say I had a cheekbone implant of this type. It would not heal on its own (neither would lypholized cartiledge) as REAL BONE would. So it's basically just another sort of implant and one that actually may have the exact if not MORE problems as medpor, peek etc.. etc.

Now if they have something truly new to reveal, i.e. that they can seed these with something that will cause real bone to grow into them and colonize the entire implant, then we have something truly interesting.

But that would be almost revolutionary and they're not even close to that yet.

I think in order to stay "natty" I'm gonna go with Dr. Zarrinabal for some Chin wing and ZSO action and then follow up with Dr. Sinn for a lefort 3
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 10:55:11 AM
As you guys know, the problem with your own bone is that if you use it as an onlay, f.e. bone from the iliac crest or from the rip, it will resorb. With children it is different. The onlays will be permanent. Unfortunately that is not the case with adults. For adults only calvarial bone would be permanent.

We would already have the perfect implant if onlays of our own bone would be permanent!

Imo Bio Oss and HA are the two best bone substitute materials for the moment, because blood vessels, arteries and new bone grow through the implant. They do not erode the underlying bone and are permanent.

I opt for Bio Oss and HA in order to stay "natty". :P
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 15, 2016, 02:33:29 PM
Everything is relevant, I know that an osteotomy could never give me the results that I wish for.

Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 15, 2016, 02:44:51 PM
Surely after 6 months the bones are well and truly fused?


Technically fused yes but they are fused after several weeks, an osteotomy is not stable at six weeks post op.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 15, 2016, 04:49:24 PM
I'm sure Z. said 6 months to me, I was super amazed too, that's how I remember. Someone should ask Z. again if he told you two months.

What Triaca did say to me however is that the fused bone is not always as strong as normal bone and that you can also see that in CAT scans: sometimes the fused bone looks much lighter than normal bone and is more difficult to see in the scan versus your normal bone. Even 6-8 months after surgery.

Makes me wonder if fused bone about 1,5+ years after surgery would be as strong as your normal bone?

f**k this is all so bizarre. Doc here who is a max fac said bone from osteotomy is almost totally fused at 4-6 weeks and that by 3 months you have total bone remodelling.

I've also heard that bone once broken and rehealed is stronger than your normal bone. Like if you break your arm it heals back stronger. Why would that not be the same for an osteotomy done on your face? Unless facial bones are different somehow?
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 15, 2016, 05:23:11 PM
f**k this is all so bizarre. Doc here who is a max fac said bone from osteotomy is almost totally fused at 4-6 weeks and that by 3 months you have total bone remodelling.

This is something that a lot of amateur jaw surgeons seem to think, (not saying the surgeon you asked was bad, it's just an observation) I have been told by arguably some of the best that this is incorrect.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: PloskoPlus on December 15, 2016, 08:33:04 PM
This is something that a lot of amateur jaw surgeons seem to think, (not saying the surgeon you asked was bad, it's just an observation) I have been told by arguably some of the best that this is incorrect.
Doctors know far less than we think they do.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 15, 2016, 09:43:49 PM
I know that an osteotomy could never give me the results that I wish for.

Mr. Fox. So please let me know: What are the alternatives to osteotomies then? Doing nothing? Waiting for a better world? :-X At least it is an improvement.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 16, 2016, 09:57:55 AM
MR. Fox will say implants.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 16, 2016, 11:20:40 AM
MR. Fox will say implants.

I think that malar osteotomies are a valid solution for those that want or suit the outcome which they can give.

I was just saying that they could never give me MY desired outcome as my natural cheekbones are a feminine shape but my taste is to have them high and lateral.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 16, 2016, 01:30:11 PM
I think that malar osteotomies are a valid solution for those that want or suit the outcome which they can give.

I was just saying that they could never give me MY desired outcome as my natural cheekbones are a feminine shape but my taste is to have them high and lateral.

I agree with you. I don't think osteotomy alone is the solution. And i'm not sure even osteotomy PLUS HA will do the trick. We would need something like the CT bone. I'm not sure yet what Bio oss is but maybe that would be better than HA?
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 16, 2016, 01:37:31 PM
Lestat said that Bio oss is a soft material like HA paste so again, it wouldn't work for me.

I hope that CT bone gets released. If not, then I will stick to cartilage implants, regardless of their tendency to resorb.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 16, 2016, 01:40:34 PM
Lestat said that Bio oss is a soft material like HA paste so again, it wouldn't work for me.

Listen, if you're willing to not engage in contact sports then the CT Bone looks okay. Also, in that video on this thread it actually says the CT bone will turnover with the metabolic cycle of the patient meaning it really does turn into real bone. So I mean hey that's our answer.

Let's proceed with CT Bone as the solution! Long live the new flesh!
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 16, 2016, 01:42:40 PM
Listen, if you're willing to not engage in contact sports then the CT Bone looks okay. Also, in that video on this thread it actually says the CT bone will turnover with the metabolic cycle of the patient meaning it really does turn into real bone. So I mean hey that's our answer.

Let's proceed with CT Bone as the solution! Long live the new flesh!

Yes it definitely sounds like the best solution 👍
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 16, 2016, 02:06:18 PM
Yes it definitely sounds like the best solution 👍

I agree, so let's now push for more information and finding when it will be available. The asset to this method is the implants can be custom designed to fit.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 16, 2016, 02:27:56 PM
Honestly, I want a solution that will address the underlying skeletal problem as soon as possible.

I don't want to spend the rest of my life waiting for more answers.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: MrFox on December 16, 2016, 03:02:16 PM
I will do everything that I can to help find when this will be available, but perhaps the company doesn't know themselves yet.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lazlo on December 16, 2016, 05:54:54 PM
anyone know if you can stack the CT 'bone' on top of each other for larger augmentations? With silicone its not a problem because it is flexible but the CT bone is rigid so you can't do 'extreme augmentations' (if your one of the few unfortunate people who legitimately need an extreme augmentation to make a difference)

CT Bone is designed to the specifications you want. So if you want an extreme augmentation you just request for one to be 3-D printed I'm assuming. It seems to me you'd be able to do the most extreme augmentations you want with this product. It's customized to your requriements.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 17, 2016, 06:59:17 AM
Imo CT Bone is failed.
Title: Re: What is the current state of Xilloc-CT Bone?
Post by: Lestat on December 27, 2016, 12:06:43 PM
Did anyone see pics in Sinn's office of his modified LF3's?

Yes Lazlo did.

Now let me tell you he showed me one patient —not Earl, but someone more recent who had the “modified lefort-3” yes there was a difference but it just resembled a weak ZSO to me. In fact, when I studied the before and after profiles there was no significant augmentation to the area directly beneath the eye and this was not as augmented as when I see Dr. Yaremchuck’s examples of orbital rim implants with “canthopexy” no Sir, not even close. Honestly from the example of the modified lefort 3 I saw this procedure is not the holy grail to your looks as many of you have been assuming I’m very sorry to report and I don’t think it can do a lot at all. You’re like to get a much more dramatic result from a genioplasty to your appearance. The problem I think rests in the facts that the movement isn’t that much AND you’re limited by your own anatomy. If you don’t have large bones they’re not gonna show very well. Also, even though this is supposedly moving the orbital rim, what is needed is more augmentation to the rim height and width itself I think.