About Bone Grafting
What is Bone Grafting?
Over a period of time, the jawbone associated with missing teeth atrophies or dissolves away. This often leaves a condition where there is poor quality and quantity of bone, unsuitable for dental implant placements. In these situations, most patients are not candidates for proper dental implant placements.
With current bone grafting techniques, the opportunity to replace insufficient bone is possible. These techniques not only provides us the ability to place implants of adequate length and width for predictable support, the regeneration of lost bone restores the functional requirements with a superior final aesthetic appearance.
Types of Bone Grafts
Autogenous Bone Grafts:
Autogenous bone grafts (autografts) are harvested from your own bone, taken from an alternate site. The bone is typically collected from the chin or jaw. Autogenous bone grafts are advantageous in that the graft material is live bone. That means autogenous bone contains living cellular elements that enhance bone growth and want to repair.
There are a number of disadvantages to using only autografting. The procedure often requires a second site with a separate entry. The quantity of bone is limited. The character and quality of the graft can be inconsistent. It is often better to mix autogenous bone with another material (making a composite graft) to attain a material that is firm enough to form new bone. Most patients do not favor multiple surgical sites if there are alternate methods of grafting.
Allogenic bone, or allograft, is donor bone harvested from a cadaver. Allografts are processed for safety followed by a freeze-drying method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on its own. It simply serves as a framework or scaffold over which your surrounding bone can grow over and through. Its best advantage over autogenous bone is that most allografts can be made to form a space for new bone growth. Properly prepared allogenic bone is completely safe since it has been processed with safety in mind. There are no living organisms, DNA, proteins or fatty tissues. The majority of the material is simply natural mineral salts found in our bodies. Over time, these grafts are dissolved away by the patients own metabolism.
Xenogenic bone is derived from donor bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenogenic grafts serve only as a framework for bone from the surrounding area to grow into and fill the void.
Both allogenic and xenogenic bone grafting are advantageous in that they do not require a second procedure to harvest your own bone, as with autografts. However, because these options lack autograft’s bone forming properties, bone regeneration may take longer than with autografts, with a less predictable outcome. But they do hold their shape and space better than many autogenous grafting techniques. This quality provides a better opportunity for bone to expand and regenerate.
Bone Graft Substitutes
As a substitute to using real bone, many synthetic materials are available as a safe and proven alternative, including:
Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA):
This product is processed allograft bone, containing collagen, proteins, and growth factors that are extracted from the allograft bone. It is available in the form of powder, putty, chips, or as a gel that can be injected through a syringe. Once again, they are completely safe to use with no disease transmissions ever reported.
Graft composites consist of other bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include: collagen/ceramic composite, which closely resembles the composition of natural bone, DBM combined with bone marrow cells, which aid in the growth of new bone, or a collagen/ceramic/autograft composite.
Bone Morphogenetic Proteins:
Bone morphogenetic proteins (BMPs) are proteins naturally produced in the body that promote and regulate bone formation and healing. These proteins are collected and sold commercially. The quality of regenerated bone using BMP products is very unpredictable.
All of these grafting materials are used universally around the globe. They are also used universally to fulfill many surgical needs far beyond Periodontics and Implant Dentistry. Back and neck fusions, fracture repairs, hip and joint replacements all share in this technology for your benefit.