Q: Dr. Eppley, I am interested in brow bone augmentation as well as orbital floor augmentation. But I don’t want to use any synthetic implant materials to do so. Can Bio-oss (bovine hydroxyapatite) be used for orbital augmentation and brow bone augmentation?
A: Any hydroxyapatite granular material can be used to augment a confined space like the orbital floor or a more open surface like that of the brow bones. Whether a bovine hydroxyapatite will persist or develop any significant bone ingrowth as an onlay material is a matter of debate. (it works best as an inlay bone substitute material) But from a handling standpoint, it can be used for either craniofacial application. Applying the material to the orbital floor is very straightforward. Applying to the brow bones, however, is a bit challenging because access to the brow bones is more restrictive. The ideal way to use it in brow bone augmentation would be an injection technique that uses a brow incision to do so.
While the concept of hydroxyapatite granules is understandably appealing, there are prone to irregularities and asymmetry when applied as an onlay graft. This would be particularly evident when introduced as an injection as the material does not have a smooth linear flow when injected out of a syringe.
Dr. Barry Eppley