bone graft in dental implants

The knowledge that we have developed in the science of dental implantology has grown tremendously in the past couple of decades, and bone grafting has developed into an integral part of it, allowing dentists to develop procedures and achieve outcomes that would not have been possible without grafting.

Bone grafting is utilized routinely in day to day procedures such as ridge preservation after tooth extraction, ridge augmentation, guided tissue regeneration in periodontal defects, ridge repair of ailing or failed implants, sinus augmentation procedures, and repair and reconstruction after surgical resection in the treatment of neoplasms. For the average dentist, bone grafting is used most commonly in ridge preservation after extractions and associated with implant placement.

A basic understanding of the available bone grafting materials , their similarities, their differences and how they work will allow the dentist to select the best material for a particular situation, since they all have their advantages and disadvantages.

Starting with the basic classification of bone grafting materials which distinguishes them by the source or where the material comes from, we have:

-Autografts: Graft material comes from the same patient (which means usually a second surgical site). Autografts are the best choice since it is the only osteogenic material.

-Allografts: Graft material comes from a different patient (human, usually a cadaver) This material undergoes extensive processing to reduce or eliminate the chances of antigenicity and disease transmission. Allografts carry bone morphogenetic proteins in a limited amount and are considered osteoinductive (can produce chemotactic signals that stimulate mesenchymal cells to differentiate into osteoblasts and form bone) and osteoconductive.

-Xenografts: This graft material comes from a different species, usually porcine or bovine and is also treated to reduce or eliminate the chances of antigenicity and disease transmission. Xenografts are osteoconductive and slower to resorb.

-Alloplasts: This is synthetic material such as tricalcium phosphate, and has the advantage of carrying no risk of antigen or disease transmission. This material is osteoconductive (acts as a matrix which maintains graft space and gets replaced by viable bone).

There has been concern recently pubicized about the safety of bone allografts due to the possibility of disease transmission to the recipient. The author is not aware of literature reports of any disease transmission by bone allograft in dentistry.It is this author’s opinion that the current FDA regulations and the donor tissue handling protocols in place today make the chance of antigen or disease transmission from allograft bone almost non-existent.

Original Source: Choose Dental