Types of Bone Graft
1. autogenous – bone taken from one area of the patient and transplanted to another area requiring such grafting
2. allograft – bone from a bone bank (cadaver bone)
3. xenograft – bovine /cow bone
Autogenous bone is the “gold standard” and oftentimes has the most predictable results. This has been described as the best type of graft because such bone is live bone with live active cellular elements that enhance bone growth, whereas other types of grafts are devoid of any active cellular material. The most common sites used to obtain the patient’s bone are Intra-oral sources such as the chin or extra-oral sources such as iliac crest, fibula, ribs, mandible or even parts of the skull. The biggest negative aspect of autogenous grafts is that an additional surgical site is required, in effect adding another potential location for post-operative pain and complications.
Allografts: An allograft is bone or soft tissue that is transplanted from one person to another. Transplanted bone, tendons, cartilage and skin are used extensively in orthopaedics, neurosurgery, as well as plastic, general and dental surgeries. In this country, over 1,000,000 allografts are transplanted each year. An allograft may be obtained from living donors who are having bone removed during surgery or cadaveric donors. Allografts are available (i) Fresh-frozen allograft (FFB) is an alternative to freeze-dried, demineralized and autogenous bone. It has excellent structural integrity, comparable to autogenous bone, but the major disadvantage is the small risk of disease transmission. (ii) Mineralized freeze-dried bone allograft (FDBA) (iii) Demineralized freeze-dried bone allograft (DFDBA). An allograft allows an easy alternative to autogenous bone for dentists to provide bone grafting services in their dental practice without the need for a second surgical site to retrieve additional bone.
In conjunction with bone grafting, membranes are often used to help stabilize the bone graft as well as displace the gum tissue from invading the healing bone graft. Gum tissue grows at a much faster rate than bone, therefore, membranes are used to prevent gum tissue from growing in and displacing the bone graft before it matures.
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