Man's first use of corals can be traced back almost to 25,000 years as evidenced through small beads of perforated red corals recovered from the burial sites in Europe. These were perhaps used as ornaments and possibility traded by early man

Jeyabaskaran, R

Khan, S Ajmal

Lyla, P S

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CORAL : "THE EXCELLENT BONE GRAFT MATERIAL" R. Jeyabaskaran, P.S. Lyla and S. Ajmal Khan Centre of Advanced Study in Marine Biology Annamalai University Man's first use of corals can be traced back almost to 25,000 years as evidenced through small beads of perforated red corals re-covered from the burial sites in Europe. These were perhaps used as ornaments and possibility traded by early man. Hard corals have little value for jewellery but are sold in souvenir shops and col-lected for displays for the expand-ing marine fish aquarium market. Dead coral rocks and living colo-nies are mined from reefs and are used for a variety of purposes as building blocks for the construc-tion of buildings, roads, piers and seawalls and for the production of lime and calcium carbide. During the past 19 years, natural coral skeleton has also been success-fully used as a bone graft material in most surgical operations. Corals have been found to be excellent bone graft materials due to their biocompatibility and osteoconductive properties. These are also cheap, widely available and can be easily prepared and shaped. Their porous structure is similar to that of bone. Corals consists of 98-99% Calcium car-bonate in the form of aragonite and Parangipel/ai - 608 502 Tamil Nadu. 1-2% amino acids and oligoelements. According to Bajpoi (1983) an ideal bone graft or substitute should be a material that is biologically inert, readily available, easily adaptable to the site in terms of shape and size and replaceable by the host bone, Cor~l skeleton when implanted into tis-sue is progressively resorbed by osteoclasts while at the same time, ostcoblasts using the freed calcium ions, produce new bonc. The skeletons of two different genera of Madreporararia namely Acoropora and Pocil/opora have been uscd as oolay graft material for contour augmentation of the face. With coral blocks or gran-ules in a SUbperiosteal fashion, patien ts wi th hemi facial microsomia, maxillary phypoplasia, micro genia and Treacher Collins' syndrome have been adequately treated. PREPARATION OF THE CORAL IMPLANTS The two coral genera Acropora and Pocillopora have been used as onlay graft material. The skeletons of the two genera have the same mineral composi-tion (aragonite) but differ in struc-ture. TheAcropora skeleton has a significant density and demon-strates highly mechanical proper-ties. Average pore diameter is 500 urn and porosity volume is about 12%. The Pocillopora skeleton consists of an extremely dense and compact wall surrounding a po-rous inside body, a structure that closely resembles bone structure. Pororsity volume is about 14% and average pore diameter of the inner part is 725 urn. The organic part of the coral is removed by immersion in a 5% solution of Sodium hy-pochlorite for 30 hrs. After the soft tissues have been oxidised, the coral is roughly shaped into the desired form with a diamond or metal but before surgical interven-tion. It can easily be reshaped more precisely during the opera-tion. After the soft tissues have been oxidised, the implant is rinsed in deinonized water for 30 hours and dried at 90°C. Sterilization before implantation is achieved by heating in an autoclave for 30 minuted at 130aC. The coral can also be mechanically fragmented and granules can be used in se-lected cases. CONCLUSION The lack of volume de-crease in the coral onlays is en-couraging. Their rapid stabiliza-tion is probably due to the in growth of connective tissue into implant pores. Coral skeleton acts as a scaffold for direct osteoblastic apposition. coral implant volume. The fate of subperiostral coral onlays needs further investigation. Furtherstud-ies on other coral genera and their related tests on animals are needed. AKNOWLEDGEMENT The authors are thankful to Late Prof. AL. Paulpandian, Former Director of our Centre, Dr. 1. Coral resorption and new bone apposition depend mainly on porosity. The larger the porosity M. Kalyani, Director and Profes- 2. sor of our Centre and authorities of Annamalai University for the en-volume, the greater the coral re- couragement and facilities. The sorption as well as the new bone first and second authors are also apposition. Coral onlays would be thankful respectively to MOE'n reliable only if bone formation is and DOD, New Delhi for the equal or almost equal to the primary financial support. P.B. No. 872 Lakshmi, XVIII/72, Parry Junction Cochin - 682 005 REFERENCES Bajpoi, P.K, 1983. Biode-gradable scaffolds in orthopaedics. Oral and max-illofacial surgery. In: Rubin LR, ed, : Biomaterials in reconstructive surgery, SL Louis, MO: CV Mosby, 312-328. Spyros, K Papacharalam bous and KI. Anastasoff, 1993. Natural coral skeleton used as onlay graft for con-tour augmention of the face. International Journal of Oral and Maxillofacial surgery, 22 : 260-264. (Exporters of Frozen Shrimps, Cuttlefish, Squids etc.) Brand'LMP' Phone: Office: 91 484231678/91 484232476 Plant AP II 643A Chemical Industrial Estate ArDor - 688 534, Alleppey Dis!. Phone: 91 478873038/91 478873274 

Coral : "The excellent bone graft material"

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Coral : "The excellent bone graft material"

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