Bone Graft Substitutes in Maxillofacial Reconstruction - Structural and Biomechanical Perspectives

Reconstruction of a maxillofacial skeletal defect in the recent past has witnessed a paradigm shift in the process of treatment planning. It has now become a collaboration between the surgeon and the bioengineer to provide a customised stable reconstruction. Understanding maxillofacial skeleton from an architectural and biomechanical perspective would not only guide the surgeon in planning a reconstruction but also the bioengineer to select the biomaterial and design an ideal reconstruction. This paper intended to provide an insight into scientific concepts which needed to be considered during the designing of biomaterials for reconstruction of maxillofacial skeletal defects. Any object in the world, from a mechanical perspective is seen only as a material of varying physical and chemical (organic / inorganic) properties dwelling in a dynamic three-dimensional environment. Bone continuously has been re-modelling by adapting to the dynamic loading environment through an established force distribution pattern of equilibrium. 1 Hence, for a patient requiring reconstruction of defects of varying dimensions within the craniomaxillofacial skeleton, its architectural complexity should be seen from both the surgeon’s and bioengineer’s perspective. Such multidisciplinary approach would provide a customized comprehensive reconstructive and rehabilitative solution.