A composite biocompatible material made of polyethyleneterephalate (Dacron) and polyetherurethane was fabricated as an aid to bone grafting for the reconstruction of large bony defects of the craniomaxillofacial regions. Bone graft material is placed within the confines of the Dacron-urethane implant and new bone forms to the shape imposed by the implant. The principle application of this material has been for the reconstruction of defects of the neurocranium and of the mandible [1–5]. A number of other applications have been studied including reconstruction of long bone discontinuity defects [6], reconstruction of an infant’s anterior chest wall [19], the prosthetic replacement of large defects of the cervical trachea [7] and as a potential material for a thrombo-resistant small diameter vascular prosthesis [8].

In 2004, the New Jersey Department of Education mandated that all leadership preparation programs in the state align with the Interstate School Leadership Licensure Consortia standards. In response, 17 preparation programs established a chapter of the National Council of Professors of Educational Administration. In this article, we describe how this chapter helped build a collaborative professional learning community across the state. The collaborative work revealed that field practitioners challenged our values and beliefs and also made substantive contributions to revising preparation programs. Now more in touch with how to improve preparation programs to meet the accountability press, we continue the dialogue with our field partners.

A lightweight polymeric composite material is described for use with bone grafting for the restoration of complex contour defects of the neurocranium. Custom fabrication based on three-dimensional computed tomography provides an anatomically precise reconstruction with reestablishment of the bony integrity of the skull.

Precise reconstruction of defects of facial bones including the neurocranium is now possible with the use of CAD/CAM technology and biomaterials, such as OsteoMesh, combined with bone grafting.

In vitro tests were carried out on Dacron® samples differently knitted and on Dacron® vascular prostheses coated with various urethanes. All the materials were put in contact with human platelet-rich plasma; the subsequent assay of three platelet released substances, i.e. β-thromboglobulin, platelet factor 4 and thromboxane B2, as well as the quantification of platelet retention, were used to establish the degree of thrombogenicity of the material itself. In some cases Dacron®-urethanes composites showed better thromboresistance than any other materials conventionally used in vascular surgery.

Reconstruction of 2 cm discontinuity defects using autologous cancellous bone chips and a Dacron-urethane prosthesis was evaluated in four canine mandibles. Histologic studies were performed on specimens taken six and 12 months after bone grafting. All four grafts were completely incorporated, producing a reconstruction that conformed precisely to the desired shape. Remodeling resulted in a trabecular pattern similar to that of the normal mandible. The prosthesis was well tolerated and did not elicit an inflammatory response.

Discontinuity defects were created in the mandibles of dogs and then reconstructed immediately with fresh autogenic cancellous bone grafts and Dacron-urethane prostheses. The grafts were irradiated to a total dose of 5000 rads after waiting intervals of between 3 and 12 weeks. Nonirradiated grafts served as controls. The grafts were evaluated clinically, radiographically, and histologically. There was complete incorporation of all grafts, regardless of the interval between surgery and radiotherapy. There were no soft-tissue complications. The controls were distinguishable from the irradiated grafts only by the presence of hematopoietic bone marrow. Fibrofatty marrow was observed in the irradiated grafts. Theoretical support for this technique is found in the biology of cancellous bone grafting and the pathology of radiation injury. In view of the difficulties associated with mandibular bone grafting in preoperatively irradiated patients, a new method of reconstructing selected cancer patients who require both mandibular resection and radiotherapy is suggested.

This study presents a histologic evaluation of the healing process of dental extraction sites in dogs with and without the use of collagen sponge as an extraction site dressing. The healing process was evaluated at 3 days, 1 week, and 6 months after tooth extraction and appears comparable in both collagen-filled and nonfilled extraction sites.

The best possible implantable biomaterial for bony contour abnormalities is autogenous bone grafts. However, some conditions may be present that require use of alloplastic materials. Such alloplastic material must be inert and there should be no reaction in the body to it. The composite graft described in this chapter is a combination of the two different materials described. To have a better take, the bone graft used is ground with a craniotome, and then mixed with blood. This produces an inductive matrix that promotes osteoneogenesis. The alloplastic material is a tray or a template where the bone is placed “in”, “on”, or “under” the implant to allow for complete solidification and better healing. The material used is polyetherurethane-impregnated terephthalate (Dacon) also referred to as osteomesh (R) (Xomed Corporation, Jacksonville, Florida). In a few instances the osteomesh was removed and we noted complete solidification of the bone (resembling skull in the case of the skull defect). For over eleven years, since the success in the experimental animal [1], this composite graft was used in clinical situations with good success [2] in over 100 patients. These patients treated were selected and a strict set of indications and contraindications were instituted and implemented, prior to the applications of this treatment in the individual patient.

Surgical resection and replacement of a segment of the cervical trachea was performed in 8 mongrel dogs. The replacement was with a porous prosthesis made of Dacron cloth mesh stiffened with a heat-curing polyetherurethane. Ten tracheal rings were resected in each animal to create a complete circumferential defect of the trachea measuring 7 or 8 cm in length depending on the size of the dog. Animals were sacrificed periodically from 3 to 27 months post-reconstruction. The luminal surfaces of the reconstructed tracheae showed respiratory epithelium.

A new universal arch bar for intermaxillary fixation has been developed. This arch bar was fabricated as a wave-shaped, thin metal plate with soldered buttons on the bucco-labial aspect. It is light and flexible, yet strong enough to provide excellent fixation in the treatment of fractures of the maxilla and/or mandible. It is a universal bar: the superior and inferior borders are identical. Clinical application has been broad including trauma and cases of orthognathic surgery.

Mandibular lengthening in mongrel dogs was evaluated in four animals. Extraoral approaches were used for mandibular exposure. Step osteotomies were performed on the buccal aspect and oblique osteotomies were performed on the lingual aspect of the mandible. The anterior fragment of the mandible was advanced 10 mm. A Dacron-urethane mesh tray, in the form of the mandible, was placed across the defect as a container of bone graft material and to help stabilize the segments. The bone graft material was harvested by aspirating the bone particles formed when the osteotomy cuts were made, thus creating a bone slurry which was placed within the implant. The results suggest that the use of the implant tray in conjunction with the bone slurry provided an appropriate physiologic setting for rapid new bone formation, restoring continuity to the defect.