Certain clinical conditions exist in which a section of cranial bone i
s removed but not immediately replaced at the initial procedure. Prese
rvation of this bone can provide a valuable autogeneous donor source f
or a future reconstructive procedure. The purpose of our study was to
compare the volume retention of fresh autogenous bone with that of pre
served autogenous bone as inlay and onlay cranial grafts. Two bone gra
fts were harvested from the skull of 15 adult New Zealand White rabbit
s. The graft volumes were calculated, and the grafts were preserved in
a normal saline-antibiotic solution at -20 degrees C. Three months la
ter, during the second procedure, a fresh graft was harvested and then
placed in the preexisting occipital defect as an inlay graft. Also at
this time, the preserved grafts were placed, one as an inlay graft in
the fresh occipital defect and the other as an onlay graft in the fro
ntal region. The animals were sacrificed 3 months later, and the perce
nt age of graft volume retention was determined. The fresh inlay graft
s had a mean volume retention of 85.1 percent, while the preserved inl
ay and onlay grafts had 61.8 and 75.9 percent mean volume retention, r
espectively. It is concluded that while fresh cranial autograft remain
s the ''gold standard'' for craniofacial reconstruction, preserved aut
ogenous cranial bone is a viable alternative for inlay and onlay graft
ing of the craniofacial region.