Bone grafts in craniofacial surgery.

Bone grafting or bone replacement is an integral part of craniofacial surgery. Most craniofacial surgeons prefer the use of autogenous bone; however, there are exceptions to this, because some plastic surgeons prefer the use of alloplastic implants for replacement of parts or missing segments in the craniomaxillofacial skeleton. Inlay bone grafts are useful in osteotomies because they show little resorption. Onlay bone grafts contour and balance the face aesthetically and enable the surgeon to obtain refinement and fine-tuning in all types of craniofacial reconstruction. These grafts demonstrate more resorption than inlay grafts. However, the use of onlay grafts coupled with soft-tissue shifts of galea and muscle enable the craniofacial surgeon to achieve superior results over those of surgeons primarily concerned with jaw- or tooth-related movements that do not utilize primary bone grafting as a method of augmentation. Superior results today are obtained with various methods and techniques of bone grafting, some of which have been described in this article.