Bone Grafting

WHAT IS BONE GRAFTING?

Over a period of time, the jaw bone associated with missing teeth atrophies and 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.

Major & Minor Bone Grafting

 

Over a period of time, the jawbone associated with missing teeth atrophies or 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.

Today, we have the ability to grow bone where needed. 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 aesthetic appearance.

Major Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. The bone graft can be obtained from either the patient’s own bone or from a bone bank or synthetic product. Donor sites commonly used include jaws, hip (iliac crest), tibia, and skull (calvarium). 

New technologies including r-BMP-2 and platelet-rich plasma are used by Drs. Pavlick and Reppas to improve graft success rates and often times avoid using bone from a separate donor site.

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 the chin, jaw, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is live bone, meaning it contains living cellular elements that enhance bone growth.

Allogenic Bone:

Allogenic bone, or allograft, is non-living bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on it’s own. Rather, it serves as a framework or scaffold over which your own bone from the surrounding bony walls can grow to fill the defect or void.

Xenogenic Bone:

Xenogenic bone is derived from non-living 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 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.

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.

Graft Composites:

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. Concentrated levels of BMPs have been developed that can stimulate your body to form bone in a given region. This can result in predictable and dramatic bone formation to accomodate dental implants.

Synthetic materials also 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. Drs. Pavlick and Reppas will determine which type of bone graft material is right for you.

Bone Grafting Overview

For a brief narrated overview of the bone grafting process, please click the image on the right. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about bone grafting.

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