About Bone Grafting
What is Bone Grafting?
Over a period of time, the jaw bone associated with missing teeth atrophies and is resorbed. This often leaves a condition in which there is poor quality and quantity of bone that is not suitable for the placement of dental implants. In these situations, most patients are not candidates for the placement of dental implants.
With bone grafting we have the opportunity to not only replace bone where it is missing, but we also have the ability to promote new bone growth in some situations. This gives us the opportunity to place implants of proper length and width to restore functionality and aesthetic appearance.
Types of Bone Grafts
Autogenous Bone Grafts
Autogenous bone grafts, also known as autografts, are from your own bone. They are taken from somewhere else in the body and transferred to the jaw or facial skeleton. 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 your own live bone, meaning it contains living cellular elements that enhances bone growth.
However, one downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on your medical conditions, a second procedure may not be recommended.
Allogenic bone, or allograft, is bone harvested from a cadaver that is then processed using a method sterilize the bone for use in patients. Unlike autogenous bone, allogenic bone cannot necessarily 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, 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 have an advantage of not requiring 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 grafting has many variables and cannot always be predictable which could necessitate further surgeries.
Bone Graft Substitutes
As a substitute to using real bone, synthetic materials are available as alternatives, 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 surgical risk and pain. Each bone grafting option has its own risks and benefits. Dr. Werner, Dr. Rubel, Dr. Strange or Dr. Madson will determine which type of bone graft material best suited to your particular needs.