Bone Grafting

Bone Grafting Materials | Sinus Lift | Ridge Expansion/Augmentation | Socket Graft | Nerve Repositioning |
Alveolar Cleft Repair | Onlay Grafting | Split Ridge/Ridge Widening | Iliac Crest Bone Graft (ICBG) |
Tibial Bone Graft | Platelet Rich Plasma

Bone grafting is often necessary in the facial and jaw bones. There are many reasons we may need to graft bone. Loss of bone due to traumatic injuries, cancer, other disease processes and most commonly due to loss of teeth. Reconstructive surgery is another reason bone grafting may be necessary. These reconstructive surgeries include lengthening bone, cosmetic correction of bony (hard tissue) defects or imbalance, cleft palate and/or alveolus, and orthognathic surgery.

Today we have many choices for bone graft materials. Some of these graft materials are natural and some are synthetic. Some actually contain bone mineral (hydroxylapatite) and some do not. Bone transplants are often a very important and necessary treatment option.

Autograft

At the top of the list of bone grafting materials is autograft. This is a small amount of your own bone taken from another part of your body and transplanted where it’s needed. The “donor site” is the place it comes from. This may be almost any bone but the common choices are;

Many times the patient's own donor bone needs to be augmented with another source of bone or it may be preferable to not use any patient bone at all. In these cases several options exist, allograft, xenograft and synthetics are available for bone grafting.

Allograft

Allograft is donated human tissue that is processed and then transplanted or implanted into another person. The tissue can be hard tissue (bone) or soft tissue (dermis, tendons, ligaments, etc.). Allograft tissue provided by tissue banks comes from donors after their complete medical and social history has been reviewed.

Allograft procedures have been performed for more than a century. Second only to blood transfusions, bone is the most commonly transplanted tissue. An estimated 450,000 people receive bone allografts each year. Most are used in dental or orthopedic procedures. The “banking” of bone for future use is also a well established practice, dating back to the first bone bank, established in the 1950’s by the US Navy.

Donor tissue is aseptically processed and converted into various forms. Some are formed from the hard outer portion of bone (cortical), the more porous bone sections (cancellous), or a combination of both. Tissue Banks require an extensive screening of all potential donors’ medical, social and family histories, based on recommended guidelines from the Centers for Disease Control. Multiple tests of donor blood for communicable diseases (HIV, hepatitis, syphilis, etc.) are also performed. Tissue deemed acceptable is recovered by trained medical personnel under strict, sterile conditions.

Tissue is then aseptically processed in a microbe free environment where it undergoes various safety-enhancing procedures.

Following the transplant, your body should begin the natural process of bone formation known as osteogenesis. The allograft tissue acts to provide a scaffolding or support system which permits bony ingrowth (osteoconduction) and promotes the formation of new bone (osteoinduction). Eventually, the allograft tissue is replaced by your own new bone. This bone growth is the end goal of transplantation. It is another reason why the source of your allograft is important. Strict processing methods ensure that allografts retain important biologic and biomechanical characteristics. This facilitates faster and greater bone formation.

Xenograft

Xenograft is bone from another living creature. The most common is bovine (cow) bone. The bone comes from an isolated herd that is not in contact with the general herds we obtain meat from. The bone is processed to remove all cellular material leaving only the bone mineral. No allergic reactions have been observed following bovine bone transplantation because allergies are triggered by proteins. All proteins have been removed from the bone leaving only the minerals (calcium and phosphate).

C-Graft™ is another Xenograft but its source is coralline officinalis, a sea coral-like marine algae. It is a natural non-animal source of pentacalcium phosphate. It has a porous structure that allows for movement of the patients bone cells into the graft material (osteoconduction). The porosity mimics that of human bone. It is completely absorbed and changed into the patients own bone over a 2 year period.

Bioplant

Bioplant™ is a synthetic bone substitute (alloplast). Bioplant material is a patented co-polymer derived from a proprietary process combining polymethylmethacrylate ("PMMA") and polyhydroxyethylmethacrylate ("PHEMA"). Additionally, they contain very thin layers of barium sulfate (for radiopacity) and calcium hydroxide. These substances have been used for bone substitutes and grafts for many years. It has been extensively studied. Bioplant has properties that enhance bone growth.

Biogran/Perioglass

Biogran™ and Perioglass™ are synthetics called bioactive glass because it is a clear granule like white sand. It consists of calcium phosphate covering silica. The Biogran™ and Perioglass™ is fully absorbed by the body and turned into bone mineral, CO2 and water. The CO2 is released to the atmosphere when you exhale. The process takes approximately 6 months or more.