title: Bone replacement in head and neck surgery: a biocompatible alternative.
abstract: BACKGROUND
  Defects in the skull have presented difficult reconstructive problems. Recently glass-ionomer cement and preformed. implants have been used to repair bony defects in the skull base and in cranio-facial surgery. Three patients are reported to illustrate possible applications for this new material.
  
  
  METHODS
  Ionocap cement and Ionoroc-skull standardized implants have been used. The cement is available as a two component blister pack. When mixed and blended a gel is produced which can be worked for approximately 5 min before hardening. It can then be contoured and drilled to the required shape. The resultant material is biocompatible and biostable, is non-toxic and permanently bonds to bone with no increase in temperature or shrinkage.
  
  
  RESULTS
  The material has been used to fill the temporal defect left by transplantation of the temporalis muscle for oral reconstruction, the anterior and lateral walls of the maxilla and following craniofacial resection, the posterior wall of the frontal sinus and anterior skull base.
  
  
  CONCLUSIONS
  Three patients with different reconstructive problems have been presented to illustrate the use of an alloplastic material that has a tensile strength similar to bone and firmly adheres to it. The material was found to be safe and easy to use. All three patients have now been followed for 12 months with no adverse affects.
authors.affiliation: Department of Otolaryngology, Head & Neck and Facio-Maxillary Surgery, Sutherland Hospital, Caringbah, Sydney, Australia.
authors.forename: I
authors.initials: I
authors.lastname: Cole
authors.forename: N
authors.initials: N
authors.lastname: Dan
authors.forename: A
authors.initials: A
authors.lastname: Anker
mesh_terms: D000368:Aged; D000538:Aluminum Silicates; D001672:Biocompatible Materials; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D005899:Glass Ionomer Cements; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D012886:Skull / Q000601:surgery*; D012888:Skull Neoplasms / Q000601:surgery
chemical_list: D000538:Aluminum Silicates; D001672:Biocompatible Materials; D005899:Glass Ionomer Cements; C088058:polymaleinate ionomer