Clinical experience in cranial and facial reconstruction with demineralized bone.

While autogenous bone is the preferred building material for skull and facial bone reconstruction, it has definite disadvantages that make the continued use of alloplastic materials inviting. Studies in the past few years have generated considerable publicity about demineralized bone as a possible substitute for autogenous bone. A clinical study using commercially available, demineralized bone in 25 patients with a follow-up period of 6 to 18 months was completed. Results indicated that where there was a functional need or the environment (tissue envelope) was satisfactory, the demineralized bone induced osteogenesis; otherwise, there was considerable resorption of the implant. This implies that, for filling bony defects or reconstructing posttraumatic deformities, the implant generally worked fairly well, while attempts to augment bony contours, especially large areas such as the forehead, were generally not satisfactory. Even where there was a functional need for bone, a significant degree of unpredictable resorption of the demineralized implant occurred.