What Is Bone Grafting?
Bone grafting is used for many reasons, most commonly for dental implants.
Patients with a jawbone that has an inadequate bone structure due to previous tooth extractions, gum disease, or injuries are not suitable candidates for dental implants. However, with bone grafting, these implant sites can be repaired.
About Bone Grafting
Bone is obtained from a tissue bank or taken from the patient — usually from the jaw, hip, or tibia (shin bone) and placed in the implant site. Special membranes that dissolve under the gum to protect the bone graft and encourage bone regeneration may also be used. This is called guided bone regeneration or guided tissue regeneration.
Bone grafting is also used for sinus bone grafts. These grafts are placed where the back upper teeth used to be, and they are used to repair defects of the jaws as a result of traumatic injuries, tumor surgery, long-term tooth loss, or congenital defects. Depending on the size of the defect, bone can be harvested from several different sites.
Types of Bone Grafts
Also known as autografts, these are bone grafts made from the patient’s own bone, taken from somewhere else in the body, typically the chin, jaw, shin bone (tibia), hip, or skull. The advantage of this type of graft is that the material is live bone containing living cells that enhance bone growth. The downside the procedure to harvest bone is an additional surgery.
Allogenic and Xenogenic Bone
These types of bone grafts are nonliving bone that cannot produce new bone on its own. Instead, they serve as a framework for bone from the surrounding area to fill the void. Allogenic bone, also called allograft, is harvested from a cadaver. Xenogenic bone is harvested from another species, usually a cow. Both are processed to avoid the potential for immune rejection. These bone grafts are advantageous because they do not require an additional procedure to harvest bone, but they lack autograft’s bone-forming properties, so bone regeneration may take longer 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. They have the advantage of avoiding an additional procedure to harvest bone along with the associated pain and recovery time.
- Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA): This product is processed allograft bone containing collagen, proteins, and growth factors. It is available in the form of powder, putty, chips, or as a gel that can be injected through a syringe.
- Graft Composites: These consist of other bone graft materials and growth factors to achieve the benefits of a variety of substances. Combinations include collagen and ceramic, which closely resembles the composition of natural bone; DBM combined with bone marrow cells to aid in the growth of new bone; and collagen, ceramic, and autograft.
- Bone Morphogenetic Proteins (BMP): These are proteins naturally produced in the body that promote and regulate bone formation and healing.