Alloplasts and biointegration.

During the past 2000 years, medical science has embraced the use of alloplastic materials to improve and replace many bodily functions. During the past 50 years, there has been a virtual explosion of alloplastic implant and device technologies. Alloplasts have been borrowed from industry with few if any modifications. Experimental and clinical studies have shown that smooth, textured, and fabric-surfaced alloplasts excite a fibrous capsule around the implant and distance normal tissue and vascularity from the implant-tissue interface. In contrast, some porous alloplasts have been shown to bond with tissues, reducing the fibrous encapsulation and promoting vascularization. The physical and chemical stability of the implant in situ and its surface composition, texture, and pore size significantly influence the tissue response. Lessons learned during the past 50 years are now being translated into new medicine-specific alloplasts.