About Bone Grafting
What is Bone Grafting?
Over a period of time, the jaw bone 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 the placement of dental implants. In these situations, most patients are not candidates for the placement of dental implants.
With bone grafting we now have the opportunity to not only replace bone where it is missing, but we also have 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 aesthetic 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, jaw, or hip. Autogenous bone grafts are advantageous in that the graft material is your own live bone, meaning it contains living cellular elements that enhances bone growth, also eliminating the risk of your body rejecting the graft material since it comes from you.
However, 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 recommended.
Allogenic bone, or allograft, is dead bone harvested from a human cadaver, then processed using a freeze-dry method to extract the water via a vacuum. These are obtained from FDA approved tissue banks. It is well cleaned, sterile, and free of viruses. 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 is derived from non-living bone of another species, usually a cow (Bovine). The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. All organic material is removed leaving only the hydroxyapatite component. It is very porous and has almost the same natural structure as natural bone. 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 have an advantage of not requiring a second procedure to harvest your own bone, as with autografts. However, because these options lack autograft’s bone-forming properties, bone regeneration may take longer than with autografts. Bone dust can also be collected in a suction screen at the time of surgery to augment your Xenogenic or Allogenic bone graft with autogenous bone.
Each bone grafting option has its own risks and benefits. Drs. Hlady, Lutchka or Thatcher will determine which type of bone graft material is best suited to your particular needs.
It may be necessary to place a resorbable collagen membrane/plug or a non-resorbable membrane (Teflon or Titanium) over a bone graft to guide the bone formation and enhance the outcome. This is called Guided Bone Regeneration. The membrane helps hold the bone graft in place, prevents the loss of bone graft particles, prevents in-growth of soft tissue into the area and guides the new bone formation. Collagen is a connective tissue protein underlying your skin which makes it tough and rubbery. The collagen will mostly dissolve from the surgical area but the Teflon or titanium will need to be removed with a secondary procedure.