[Use of porous hydroxyapatite in reconstructive maxillofacial surgery]

The use of porous hydroxyapatite (HA) (Interpore 200) in blocks as well as in particulate form is presented based upon experience from 99 maxillofacial reconstructions. The indications have been local defects of the alveolar process after trauma and resections due to tumors, the edentulous atrophic alveolar ridge, secondary residual clefts, and bone defects associated with orthognathic surgery. Clinical, radiologic and histologic findings after a follow-up period up to 3 years showed that there is an indication for HA blocks and particulate HA in orthognathic surgery, and that relatively stable results with few complications can be achieved with particulate HA in reconstructions of local bone defects and the atrophic alveolar ridge. Bone ingrowth through the implant material is seen when HA blocks are used. With particulate HA a fibrous encapsulation of the granules is formed. To a certain extent HA may replace the use of autogenous bone, but with major maxillofacial reconstructions it seems that the use of autogenous bone is still mandatory.