Bone transplantation and bone replacement materials

There is a growing need for immediately available material with appropriate qualities for reconstruction of large bone defects. Autologous spongy bone grafts are optimal as to biocompatibility, but are in short supply. Allogenic and xenogenic bone grafts evoke an immunological reaction after implantation and are not biocompatible. In the last thirty years ceramic implants and composites have been developed for bone substitution. New calcium phosphate bone substitutes undergo processes of resorption and precipitation of carbonate apatite that play a part in formation of new bone. These materials are easy to use because of their pastelike consistence. Resorption properties are influenced by particle size, crystallinity and composition. So far, no serious adverse reactions were reported. More clinical experience is necessary especially with composites and combinations with antibiotics, bone growth factors and collagen, to specify the place of these modern calcium phosphates in bone replacement and bone substitution.