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首页> 外文期刊>Journal of drugs in dermatology: JDD >Aesthetic applications of calcium hydroxylapatite volumizing filler: An evidence-based review and discussion of current concepts: (Part 1 of 2)
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Aesthetic applications of calcium hydroxylapatite volumizing filler: An evidence-based review and discussion of current concepts: (Part 1 of 2)

机译：羟基磷灰石钙填充填料的美学应用：基于证据的当前概念审查和讨论：（第1部分，共2部分）

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BACKGROUND: Calcium hydroxylapatite filler (CaHA; Radiesse) is a synthetic, non-animal derived product composed of minerals that occur naturally in bone and teeth. Following its development in the US, initial approval by the US FDA for non-aesthetic indications and CE marking in Europe, it was used off FDA-labeling for aesthetic purposes. Its use has grown further since its FDA approval in 2006 for long-lasting correction of moderate to severe wrinkles and folds. It is a popular filler for volume restoration to the face, and also to nonfacial areas such as the dorsum of the hands. METHODS: The first article of this two-part series provides an evidence-based review of study data pertaining to the mechanism of action and biocompatibility of CaHA filler, and its safety, efficacy and tolerability when used for aesthetic purposes. The review includes data from a number of prospective, controlled comparative studies, from several retrospective studies, and from a meta-analysis of reported complications from alloplastic filler procedures over a 20-year period. The study methodology and number of study subjects are sufficiently robust to provide a high Evidence Level for much of the data. RESULTS: CaHA has good safety, efficacy and tolerability profiles that are comparable to those of hyaluronic acid (HA) fillers. It provides an initial, immediate volume replacement for up to 12 months followed by longer term correction due to biostimulation, resulting in collagenesis. Evidence Level II studies show longevity of 30 months or more after nasolabial fold implantation. Other studies demonstrate the appropriateness of CaHA filler for volume restoration to areas including the mid face, lower face and hands. CaHA is classified as an adjustable filler, whereas HA is fully reversible by hyaluronidase digestion. For this reason, and also because of CaHA's high viscosity and elasticity, evidence-based and experiential consensus suggests its avoidance in highly mobile areas (e.g. lips) or in anatomically unforgiving areas (e.g. the periocular region), where there may be increased incidence of nodules. CONCLUSION: CaHA filler is safe, efficacious and well-tolerated when used appropriately. It is increasingly recognized that many patients require pan-facial volume restoration, and that many can benefit from combined treatments. Therefore, CaHA and HA fillers may be considered complementary rather than competitive to each other. The second article of this series offers a discussion of product characteristics, scientific principles and injection techniques to optimize treatment with CaHA filler, including special considerations for avoidance and management of complications.
机译：背景：羟磷灰石钙填料（CaHA; Radiesse）是一种合成的，非动物来源的产品，由天然存在于骨骼和牙齿中的矿物质组成。在美国发展之后，美国FDA首次批准了非美学适应症和欧洲的CE标记，出于美学目的，将其从FDA标签中删除。自2006年获得FDA批准以来，该产品的用途得到了进一步的发展，可对中度至严重的皱纹和皱褶进行长期矫正。它是用于面部和非面部区域（例如手背）的体积恢复的常用填充剂。方法：这个由两部分组成的系列文章的第一篇文章以证据为基础，回顾了有关CaHA填充剂的作用机理和生物相容性及其在美学目的上的安全性，有效性和耐受性的研究数据。该综述包括来自许多前瞻性，对照比较研究，若干回顾性研究的数据，以及来自20年间同种异体填充物手术所报告并发症的荟萃分析。研究方法和研究对象的数量足够强大，可以为许多数据提供较高的证据水平。结果：CaHA具有与透明质酸（HA）填充剂相当的安全性，功效和耐受性特征。它可以提供长达12个月的立即体积替换，随后由于生物刺激而需要长期校正，从而导致胶原蛋白变性。二级证据表明，鼻唇沟植入后的寿命可以达到30个月或更长时间。其他研究表明，CaHA填充剂适用于中脸，下脸和手等部位的体积恢复。 CaHA被分类为可调节填充物，而HA通过透明质酸酶消化可完全逆转。因此，也由于CaHA的高粘度和弹性，基于证据和经验的共识表明，应避免在活动性较高的区域（例如嘴唇）或在解剖学上不宽容的区域（例如眼周区域）使用，因为可能会增加结节。结论：正确使用CaHA填料是安全，有效和耐受性良好的。越来越多的人认识到许多患者需要全脸面容恢复，并且许多人可以从联合治疗中受益。因此，CaHA和HA填充剂可以被认为是互补的，而不是彼此竞争。本系列的第二篇文章讨论了产品特性，科学原理和注射技术，以优化用CaHA填充剂的治疗，包括避免和管理并发症的特殊注意事项。

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