what is Bone Grafting?
Over a period of time, the jaw bone associated with missing teeth atrophies and is resorbed. This often results in an inadequate quantity of bone suitable for the placement of dental implants, as well as the bone remaining being of poor quality. In these situations, most patients are not candidates for the placement of dental implants.
Performing bone grafting, however, provides the opportunity to not only replace bone where it is missing, but facilitates the promotion of new bone growth in that location. This enables the placement of implants of proper length and width, ultimately making it possible for functionality and an esthetic appearance to be restored.
Types of Bone Grafts
Autogenous Bone Grafts
Autogenous bone grafts, also known as autografts, are prepared using one’s own bone that has been harvested from elsewhere in the body, typically from the chin, jaw, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is one’s own live bone, which not only contains living cellular elements that enhance bone growth, but as autogenous bone grafts come from one’s own body, the risk of the graft material being rejected is eliminated.
However, one downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on one’s condition, a second procedure may not be recommended.
Allogenic Bone Grafts
Allogenic bone grafts, also known as allografts, are composed of dead bone harvested from a cadaver. This bone is then processed using a freeze-dry method that also vacuum-extracts the moisture. Unlike autogenous bone, allogenic bone cannot produce new bone. 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 Grafts
Xenogenic bone is derived from non-living bone of another species, usually that of a cow. The bone is processed at very high temperatures to avoid the potential for contamination and immune rejection. 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 have the advantage of not requiring a second procedure to harvest one’s own bone, as with autografts. However, without the bone-forming properties inherent in autografts, bone regeneration may take longer using these grafting methods, and also have a less predictable outcome.
Bone Graft Substitutes
As an alternative to using real bone, many synthetic materials are available to be used as bone graft substitutes. They include the following safe and proven products:
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 into the surgical site.
Graft composites consist of a combination of bone graft materials and growth factors that together achieve the benefits of a variety of substances. Some combinations include: a collagen/ceramic composite, which closely resembles the composition of natural bone, demineralized bone matrix (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, which function to promote and regulate bone formation and healing.
Using synthetic materials for bone grafting procedures, also has the advantage of not requiring a second procedure to harvest bone, reducing risk and discomfort expected when a secondary site is also undergoing healing following a surgical procedure. There are advantages and disadvantages associated with each bone grafting option. Dr. Özcan will determine which type of bone graft material is best suited to one’s particular needs.