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 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.
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 or jaw. In our office other non-oral bone sources are not used. Autogenous bone grafts are advantageous in that the graft material is live bone, meaning it contains living cellular elements that enhance bone growth.
However, one downside to the autograft is that it often requires a second procedure or surgical site to harvest bone. Also the amount of autogenous bone available is limited, so this graft option is only used for small grafting procedures. Depending on your situation, use of autogenous bone material may not be possible or advisable.
Allogenic bone, or allograft, is bone harvested from human donors and is obtained from a tissue bank. We use allograft bone only from certified and licensed tissue banks. Donors and bone are both carefully screened and tested prior to use ensuring good health. The bone is then processed and sterilized using a freeze-dry method to extract the water via a vacuum. These grafts do not contain living cells and are essentially mineral granules. 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 cells from the surrounding bony walls can grow to fill the defect or void thus creating new 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. Also the amount of graft available is not limited. 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 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. Drs. Allain or Monzingo will determine which type of bone graft material is right for you.