About Bone Grafting

What is Bone Grafting?

Over a period of time, the jawbone associated with missing teeth atrophies is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

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

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, meaning it contains living cellular elements that enhance bone growth.

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 in your best interest.

Synthetic Bone substitutes.

Wayne uses beta Tricalcium Phosphate (bTCP) and / or Hydroxy Apatite cystals. Which are purely synthetic materials not derived from another living creature. The risk of transmission of infection is thus nil. Wayne combines this with your own growth factors using a Platelet Rich Fibrin matrix made by taking your own blood and centrifuging out your own proteins and growth factors that enhance growth. Similarly Wayne manufactures fibrin sheets made from your own serum rather than use animal derived collagen products.  As most patients have procedures under IV sedation there is no additional injections required and the blood can be taken from your IV cannula.

Synthetic materials also have the advantage of not requiring a second procedure to harvest bone, reducing risk and pain. Each bone grafting option has its own risks and benefits. Wayne will determine which type of bone graft material is right for you.

Allogenic Bone:

Wayne does not use this technique as better options are available.

Allogenic bone, or allograft, is dead bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on its 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:

Wayne does not use this technique now although many in Wellington still do. There are better options without risk of prion disease such as mad cow disease (although this risk is extremely extremely low).

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 with autografts. However, because these options lack autografts bone-forming properties, bone regeneration may take longer than with autografts, with a less predictable outcome.

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):

Wayne does not use this.

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.