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Facial Plast Surg 2023; 39(05): 556-563
DOI: 10.1055/s-0043-1770962
Original Article

Bone Graft Substitutes and Enhancement in Craniomaxillofacial Surgery

Dhruv Patel
1   Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, New York
,
Sherard A. Tatum
2   Department of Otolaryngology and Pediatrics, SUNY Upstate Medical University, Syracuse, New York
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Abstract

Critical-sized bone defects are a reconstructive challenge, particularly in the craniomaxillofacial (CMF) skeleton. The “gold standard” of autologous bone grafting has been the work horse of reconstruction in both congenital and acquired defects of CMF skeleton. Autologous bone has the proper balance of the protein (or organic) matrix and mineral components with no immune response. Organic and mineral adjuncts exist that offer varying degrees of osteogenic, osteoconductive, osteoinductive, and osteostimulative properties needed for treatment of critical-sized defects. In this review, we discuss the various mostly organic and mostly mineral bone graft substitutes available for autologous bone grafting. Primarily organic bone graft substitutes/enhancers, including bone morphogenic protein, platelet-rich plasma, and other growth factors, have been utilized to support de novo bone growth in setting of critical-sized bone defects. Primarily mineral options, including various calcium salt formulation (calcium sulfate/phosphate/apatite) and bioactive glasses have been long utilized for their similar composition to bone. Yet, a bone graft substitute that can supplant autologous bone grafting is still elusive. However, case-specific utilization of bone graft substitutes offers a wider array of reconstructive options.

Keywords

bone graft substitutes - bone graft enhancement - craniofacial reconstruction - bone reconstruction - bioactive - implants


Publication History

Article published online:
20 July 2023

© 2023. Thieme. All rights reserved.

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