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Published online by Cambridge University Press: 22 February 2011
The best possible implantable biomaterial for bony contour abnormalities is autogenous bone grafts. However, some conditions may be present that require use of alloplastic materials. Such alloplastic material must be inert and there should be no reaction in the body to it. The composite graft described in this chapter is a combination of the two different materials described. To have a better take, the bone graft used is ground with a craniotome, and then mixed with blood. This produces an inductive matrix that promotes osteoneogenesis. The alloplastic material is a tray or a template where the bone is placed “in”, “on”, or “under” the implant to allow for complete solidification and better healing. The material used is polyetherurethane-impregnated terephthalate (Dacon) also referred to as osteomesh (R) (Xomed Corporation, Jacksonville, Florida). In a few instances the osteomesh was removed and we noted complete solidification of the bone (resembling skull in the case of the skull defect). For over eleven years, since the success in the experimental animal [1], this composite graft was used in clinical situations with good success [2] in over 100 patients. These patients treated were selected and a strict set of indications and contraindications were instituted and implemented, prior to the applications of this treatment in the individual patient.