Bone Grafting

Bone grafting is the use of using either the patient's own bone harvested from another site on the body, or from a donor, or a synthetically made, biocompatible substitute to replace or encourage bone growth where needed. In dentistry bone grafting is done to replace or reshape the jaw bone so that it can support dentistry treatments and procedures such as implants, change the shape of the face, or repair a facial injury (reconstructive facial surgery for example.) It can also be used to repair damage caused by diseases and infections of the mouth such as periodontitis and gingivitis.

What does Bone Grafting have to do with Dentistry?

In cases of dentistry, a bone graft can be vital to reshape or add enough bone density so that it can support a range of implantsfor replacing teeth. Most Dental implants need to be inserted into bone in order to stay fixed in place, but this cannot be done without the jaw bone having sufficient bone mass for implant, which is where bone grafting can help. Bone grafting in dentistry is also used to correct facial trauma to the jaw bone, or repair bone mass and strength after gum disease or infection or from being worn down by dentures or other treatments. It can also be used in combination with other dental treatments such as tissue grafting.

Bone Graft types

There are many different types of bone graft available today. Autografts, (sometimes known as autogenous or autologous bone grafting) are usually the most successful bone grafts as the bone used is taken from the patient receiving the bone, only from a different part of the body such as the ribs, chin or even the skull!. Because it is taken from the same person, there is less chance of the body rejecting it. The downside of autografts is that it means the patient has two surgical procedures, (one to remove bone, one to graft it,) which raises the risk of infection by having two healing sites rather than one.

Allograft is a type of bone grafting that uses bone donated by another human donor, usually from a cadaver (deceased donor) or bone banks. The compatibility is usually tested before grafting, to help minimize rejection. As the bone is from another human being, there is an increased chance of it being rejected by the patient. There is also a very small risk (small because it is tested very thoroughly first) of transferring diseases such as hepatitis, HIV etc.

Artificial bone grafts uses artificial bone made with synthetic materials such as calcium phosphate, bioglass and calcium sulphate. The artificial bone does have an advantage over allograft in that it will not transfer diseases and has a lower rejection rate although there still is a risk of rejection. The similar alloplastic grafts also uses materials that closely resemble the bone such as hydroxylapetite and bioactive glass. Some synthetic bone grafts are made of calcium carbonate which is easily reabsorbed, which can leave the grafted area vulnerable to breakage again.

Xenografts involves the bone grafting material being sourced from animal donors, such as bovines (cows) Natural bone growth is encouraged by this form of bone graft, but some patients, such as vegetarians, vegans and animal rights protesters may find it difficult to ethically accept an animal donor.

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