Bone grafting

A prerequisite for implantation is a sufficient volume of bone in the jaw, making it possible to securely and stably anchor dental implants.

However, if the residual bone volume is insufficient, bone transplantation (grafting) is necessary.

WHAT ARE THE BONE GRAFTING MATERIALS?

Materials for bone grafting or bone augmentation can be:

• Autogenous bone material (the recipient and donor is the same person);
• Allogeneic bone material (the recipient and donor are different people);
• Xenogeneic bone substitute (obtained from animals);
• Alloplastic materials – substitutes for natural bone material (made synthetically).Alloplastic materials – substitutes for natural bone material (made synthetically).

An autogenous, that is, one’s bone graft, is considered particularly suitable because it is well tolerated and is directly involved in the formation and development of new bone. In this method, the bone is taken from the iliac crest or mandible angle area. The disadvantage is that we can get a minimal amount of material, and this method requires additional surgical intervention.

Allogeneic bone material. The advantages of allogeneic bone material are that it is available in any quantity and does not require additional surgery to harvest bone tissue. However, like any organ transplant, it can trigger an immune response in the recipient. There is also a risk of transmission of pathogenic microorganisms (bacteria, viruses, prions). Longer bone formation times should also be expected since allogeneic bone does not have the same favorable formation properties as autogenous material. In recent years, good results have been achieved using xeno- and synthetic materials for human bone substitutes. Therefore, they are an excellent alternative to human bone.

AN OVERVIEW OF BONE AUGMENTATION TECHNIQUES

INLAY GRAFT. This used during tooth extraction. Bone material is placed in the extracted tooth’s socket to preserve the jaw bone volume and avoid bone resorption. This is a standard procedure for tooth extraction.
ONLAY GRAFT. This procedure is used to restore the width and height of the residual bone. Bone material is placed on the jaw’s surface, or the jaw itself is split, and the gap between the bone fragments is filled with it.
SINUS GRAFTING. The sinus is the air space in the upper jaw (maxillary sinus) that can be used for bone grafting.

Today, bone grafting or bone augmentation has become a widespread procedure in dental surgery, which gives good results with minimum complications.

CAUSES OF BONE LOSS

The reasons may be the following:
• congenital anomalies;
• trauma;
• condition after tumor-related mandibular resection;
• mandibular resorption due to inflammatory processes;
• bone loss after tooth extraction.

After tooth loss, an alveolar bone width decrease (sagittal type) tends to occur in the upper jaw, and an alveolar bone height decrease (vertical type) – in the lower jaw. The alveolar bone can shrink to a few millimeters. Prolonged use of removable dentures significantly increases alveolar bone atrophy.

CONTRAINDICATIONS FOR BONE TRANSPLANTATION:

• cardiovascular diseases;
• diabetes;
• respiratory complication;
• other conditions involving poor wound healing and significantly reduced immune system response;
• illnesses connected with impaired blood clotting;

• a neoplasm or tumor;
• acute inflammation of the sinuses (sinusitis);
• foreign bodies in maxillary sinuses;
• nicotine abuse.