Hydroxyapatite cements are a useful adjunct in treatment of deficiencies of the craniofacial skeleton. They provide a rapid and reliable method of correcting bony defects or contour deformities. Although they are alloplastic, their high degree of tissue tolerance and their demonstrated ability to incorporate within host bone make problems such as infection and extrusion rare. As with any alloplast, sound surgical principles should be used to avoid these complications. There should always be an acceptable overlying soft tissue envelope and minimal contamination of the operative site. Theoretical concerns about potential growth disturbance have not been borne out in experimental studies or by clinical experience.However, more extensive follow-up of patients will be needed to resolve these issues.