Use of a new malleable implant as a bone substitute in maxillofacial surgery

Biocompatible osteoconductive polymer (BOP) has been used since 1979 as a substitute for bone in orthopedic surgery and neurosurgery. To date, in maxillofacial surgery, loss of bone volume as a result of either trauma or osteoporosis has been compensated for by autologous bone onlay graft or subperiosteal apposition grafts of synthetic materials. Neither of these solutions is entirely satisfactory. Autologous bone is subject to reabsorption, requiring initial overcorrection and multiple reoperations to achieve an acceptable result. Preshaped implants of Proplast, Vicryl, Gore-Tex, or silicone do not offer much flexibility, and coral granules and hydroxyapatite are difficult to handle. Finally, all foreign materials can elicit problems with tolerability. In its SP (solution/powder) form, BOP is a paste that can be molded precisely to the required shape, making it ideal for maxillofacial surgery. This study examined the long-term tolerability and facial alterations after implants of BOP in 11 patients who underwent post-trauma and cosmetic surgery.