About Bone Grafting
What is Bone Grafting?
Over a period of time, the jawbone associated with missing teeth atrophies (shrinks) and disappears. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, tissue must be added in order to enable patients to be candidates for the placement of implants.
With bone grafting, we now have the opportunity to replace the missing bone and sculpt the potential implant site as well as the ability to promote new bone growth in that location! This not only gives us the chance to place implants of proper length and width, it also enables us to restore chewing function and a beautiful smile!
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, jaw, lower leg bone, hip, or the skull. 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 requires another surgical site to procure the bone from elsewhere in the body. Depending on your condition, the surgery at another site to procure this type of graft may be avoidable by using another type of graft.
Allogenic bone, or allograft, is bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot 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 and replace the original graft. This bone is generally sterilized by irradiation and is completely safe. Our doctors have had great success in using these grafts in conjunction with a derivative taken from a small amount of the patient’s own blood and prepared on the day of surgery called “Platelet Rich Plasma”. Doctors Nail and Dombrowski have equipped their office with the supplies necessary to extract these highly concentrated platelet derived growth factors and to add them to the graft and recipient site. These growth factors then serve to enhance and accelerate graft healing and patient recovery.
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 surgical site to obtain your own bone, as 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. Doctors Nail and Dombrowski use this type of bone extensively, often mixing it with the patient’s own platelet rich plasma growth factor concentrate to enhance the grafts healing and to achieve similar results to those obtained 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 additional harvest sites to obtain bone, reducing risk and pain. Each bone grafting option has its own risks and benefits. Our doctors will determine which type of bone graft material is right for you.