Is hydroxyapatite ceramic an adequate biomaterial in ossicular chain reconstruction?

The suitability of high-density hydroxyapatite ceramic without macropores for ossicular chain reconstruction was examined in animal experiments. The material was implanted both mobilely and immobilely, in compact cylinders and as granules at different locations. Biocompatibility was studied by the sawing and grinding technique without decalcification. If high-density hydroxyapatite was not in direct and stable contact with living bone, resorption and osteoneogenesis could not be observed. In cases of mobile contact with living bone there was a jointlike connection. Osteoneogenesis was seen only if the hydroxyapatite was in primary stable contact with living bone. We concluded that high-density hydroxyapatite ceramic, positioned as an ossicular replacement prosthesis, is an adequate biomaterial in ossicular chain reconstruction.