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In summary, the surgical approaches outlined in Chapter 4 of this book – the bony lid technique, the SBB technique, and the bone core technique^67,68 – nicely reflect the basic principles of successful bone healing introduced in this chapter, which are that:

1. Autografts have favorable osteoconductive properties, allowing bone to form on the surface.

2. Once harvested and used immediately, autografts can exert osteogenic properties where the transplanted cells might contribute to bone formation.

3. The osteoinductive properties of autografts are questionable, and it is desirable to avoid ectopic bone formation at soft tissue sites.

Nevertheless, the resorption of autografts releases growth factors that might support graft consolidation. The amount of resorption can be clinically controlled under certain indications, including the biologic approaches presented in this book.

The prerequisites for successful graft consolidation are mechanically stable conditions in a well-vascularized area with vital bone walls as the origin of the newly formed bone. The definitions of a gold standard should mainly be seen clinically, and defined for each indication, since experimental animal research is mostly based on a short observation time of only a few weeks. It therefore seems worthwhile to resume experimental work on the autogenous bone experiments of the pioneers, ultimately in search of molecular and cellular explanations for the definition of a gold standard.