Alloplasty is a surgical procedure performed to substitute and repair defects within the body with the use of synthetic material. It can also be performed in order to bridge wounds. The process of undergoing alloplastic involves the construction of an alloplasty graft through the use of computed tomography (CT), rapid prototyping and "the use of computer-assisted virtual model surgery." Each alloplastic graft is individually constructed and customised according to the patient's defect to address their personal health issue. Alloplastic can be applied in the form of reconstructive surgery. An example where alloplastic is applied in reconstructive surgery is in aiding cranial defects. The insertion and fixation of alloplastic implants can also be applied in cosmetic enhancement and augmentation. Since the inception of alloplastic, it has been proposed that it could be a viable alternative to other forms of transplants. The biocompatibility and customisation of alloplastic implants and grafts provides a method that may be suitable for both minor and major medical cases that may have more limitations in surgical approach. Although there has been evidence that alloplastic is a viable method for repairing and substituting defects, there are disadvantages including suitability of patient bone quality and quantity for long term implant stability, possibility of rejection of the alloplastic implant, injuring surrounding nerves, cost of procedure and long recovery times. Complications can also occur from inadequate engineering of alloplastic implants and grafts, and poor implant fixation to bone. These include infection, inflammatory reactions, the fracture of alloplastic implants and prostheses, loosening of implants or reduced or complete loss of Osseo integration generally; alloplasty requires resource-intensive preparation including a computed tomography (CT) scan of the patient. Following the CT scan, computer-assisted design technology such as interactive virtual surgical planning software, is used to design a surgical simulation. The surgical simulation produced can be utilised to manipulate the 3D CT model to “preplan the resection, design cutting guides, and choose the appropriate stock prosthesis size”. To further improve the safety and outcomes of alloplasty, additive manufacturing technology such as the use of rapid prototyping, fabricates stereo lithographic models and cutting guides to be used in the operating room to improve surgical performance.

Prior to the surgical procedure, the alloplastic implant that will be used to repair or substitute the patients defect is designed to be biocompatible with the patient's specific body tissue. The purpose and longevity of the alloplastic implant is also taken into account when considering the materials that are used to create the implant and the structure in order to be able to fixate the implant into the body safely and securely. Preventative measures taken to minimise infection include alloplastic implants being thoroughly sterilised through the administration of antibiotics, the implant acting as an antibiotic carrier. The administration of an antibiotic above the minimum biofilm eradication concentration can act as a protective barrier to bacterial adhesion but can also eradicate biofilm remnants. Another preventative measure to minimise infection is topical antiseptic cleaning in the area of operation. Patients prior to surgical procedure are to be placed on strict hygiene programs to minimise the production of harmful bacteria that may cause infection. Infection can delay the surgical procedure of the alloplastic implant which would cause the patient to further endure the disadvantages of their defect.

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Sarah eve

Editorial Assistant

Journal of Oral Hygiene and Health