About Bone Grafting
What is Bone Grafting?
Over a period of time, the jawbone associated with missing teeth atrophies and is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone, making it unsuitable for placement of dental implants. These situations, if left untreated, may mean a patient is not a candidate 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 function and an provide an esthetic appearance.
Types of Bone Grafts
Autogenous Bone Grafts:
Autogenous bone grafts, also known as autografts, are completed with your own bone, taken from somewhere else in the body. The bone is typically harvested from the chin, jaw, lower leg bone or hip. Autogenous bone grafts are advantageous in that the graft material is live bone, meaning it contains living cellular elements that enhance bone growth.
However,a downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on your condition, a second procedure may not be in your best interest.
Allogenic bone, or allograft, is sterilized bone extracted from a tissue donor, then processed using a freeze-drying method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone does not produce new bone on its own. Rather, it serves as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the bony defect.
Xenogenic bone is derived from bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. Similar to 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 is necessary 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.
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 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 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. Your surgeonwill discuss these options with you and help determine which bone graft option is right for you.