About Bone Grafting
What is Bone Grafting?
Over a period of time, the jaw bone associated with missing teeth atrophies is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.
With bone grafting, we now have the opportunity to not only replace bone where it is missing, but also the ability to promote new bone growth in that location! This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance.
What are the different types of bone grafts?
Autogenous Bone Grafts:
Autogenous bone grafts, also known as autografts, are made from your own bone, taken from somewhere else in the body. The bone is typically harvested from other areas of the mouth, the chin, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is the patient’s own living bone, meaning it contains living cellular elements that enhance bone growth.
However, downsides to the autograft include the requirement of a second site from which to harvest bone and possible limitations in quantity. Depending on your condition, a second procedure may not be in your best interest.
Allogenic bone, or allograft, is processed bone harvested from a human cadaver. Various patented processes, including a freeze-dry method, extract the water and foreign proteins. Unlike autogenous bone, allogenic bone cannot produce new bone on it’s own; rather, it serves as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the defect or void.
Xenogenic bone is derived from non-living bone of another species, such as a cow or a pig. The bone is processed to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenogenic grafts serve as a framework for bone from the surrounding area to grow 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.
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What are the bone graft substitution options?
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, denatured 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.
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.
Synthetic materials or graft material from other humans/species have the advantage of not requiring a second procedure to harvest bone, reducing risk and pain. Each bone grafting option has its own risks and benefits.