About Bone Grafting

What is Bone Grafting?

Over a period of time, the jawbone associated with missing teeth atrophies and is reabsorbed. Other bone defects result from developmental defects (maxillary clefts), pathology (cysts or tumors), or trauma. Whatever the cause,  poor quality and quantity of bone compromise a patient’s ability to be restored to proper form, function, and esthetics. In these situations, patients generally require bone grafting in coordination with their overall treatment plan.

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

Below are several different methods of grafting to increase bone volume. Each bone grafting option has its own risks and benefits. Dr. Dietrich will determine which type of bone graft material is right for you.

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.  This means that it contains living cellular elements that enhance bone growth.

One downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on your condition, a second procedure may not be in your best interest.

Allogenic Bone:

Allogenic bone, or allograft, is dead bone harvested from a cadaver. It is 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.

Xenogenic 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 required with autografts. However, because these options lack autograft’s bone-forming properties, these may only be suitable for smaller sites.

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:

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 healing and formation of new bone. Recently, these BMPs have been used to improve bone growth in areas that require grafting.