If your dentist determines you need a bone graft before placing implants, with all the options available it can be confusing deciding what material is optimal. The type of bone augmentation chosen depends on several factors from the size of the defect to costs.
For instance, small defects in areas with minimal stress during chewing can be successfully grafted with synthetic materials like hydroxyapatite or tricalcium phosphate. In more extensive defects, on the other hand, autografts sourced from your body, allografts from human donors, or xenografts from animal sources might be preferable due to their structural integrity and ability to promote natural bone growth.
Let’s explore the advantages and ideal uses of the top grafting materials to rebuild bone for implants.
Factors Affecting Choice of Bone Graft Material
Selecting the best bone graft material is a crucial decision in the process of preparing for dental implants. Your dentist plays a key role in guiding this decision, considering various factors tailored to your specific needsL
Defect Size and Location
The extent and location of the bone defect significantly influence the choice of grafting material. For small defects, particularly in areas with minimal stress during chewing, synthetic materials like hydroxyapatite or tricalcium phosphate can be effective.
In more extensive defects, autografts sourced from your body, allografts from human donors, or xenografts from animal sources might be preferable due to their structural integrity and ability to promote natural bone growth.
Compatibility with your body’s tissues is paramount. Modern grafting materials are designed to integrate seamlessly with your natural bone, encouraging new bone formation. This biocompatibility ensures a successful fusion between the graft and your existing bone, vital for long-term stability.
Cost is a practical aspect that influences the choice of grafting material. Synthetic options are often more affordable than biological grafts, making them a feasible choice for many patients. However, it’s essential to strike a balance between cost-effectiveness and the desired outcome, ensuring the chosen material meets both your budgetary constraints and clinical needs.
Predictability and Success Rates
Certain materials, like autografts, are renowned for their high success rates and predictability. While these may involve an additional surgical site to harvest bone, the enhanced integration and reduced risk of graft rejection can be invaluable, especially for complex cases. On the other hand, newer synthetic materials have shown remarkable advancements, offering excellent predictability in bone regeneration.
Review of Bone Graft Options
1. Autogenous Bone Grafts
Considered the “gold standard”, these grafts use patient’s own bone harvested typically from the jaw, chin or hip:
- Autografts contain live bone cells, growth factors, and scaffold for ideal regeneration. Up to 90% graft integration.
- No issues with rejection or foreign body response since it’s your own natural bone.
- Versatile for most defect types and locations. Can be particulated, chipped, or block bone.
- Extra surgery is necessary to obtain bone and possible donor site morbidity.
- Since it’s harvested from the patient, there’s limited bone volume available for the procedure.
Best for: Smaller defects; patients wanting extremely predictable results using their own bone.
Allografts use human donor bone acquired from cadavers or bone banks:
- Readily available in different forms without additional surgery.
- More affordable and lowers patient discomfort versus autograft harvesting.
- Contains bone scaffolding but lower number of live cells compared to autografts. Still highly effective.
- Risk of rejection or infection transmission very low with strict tissue processing protocols.
Best for: Larger defects; patients who can’t provide sufficient autograft bone.
Xenografts utilize bone from other species, usually bovine:
- Provides bone matrix scaffold for human bone to grow into.
- Avoids risks of rejection or disease transmission.
- Typically used in mix with autografts or future bone marrow aspirate procedures to induce live bone growth.
- Not replacement for autogenous bone in highly load-bearing sites on its own.
Best for: Mixing with autografts to extend bone availability.
4. Alloplastic Grafts
Synthetic bone substitutes made from materials like calcium phosphates or hydroxyapatite:
- Readily available off the shelf options with no graft rejection or infection risks.
- May incorporate into surrounding bone but do not form vital bone itself.
- Useful temporary scaffold while awaiting other grafts to grow or densify.
- May carry higher risk of graft failure or infection compared to natural bone.
Best for: Smaller contained defects; non-load bearing graft sites.
|Natural (Derived from coral or made synthetically)
|Integration with Natural Bone
|Stimulates new bone growth
|Promotes natural bone regeneration
|Available, but may be limited based on natural sources
|Manufactured in labs
|Derived from natural sources or made synthetically
Talk to your dentist and oral surgeon to select the ideal type, form, and volume of bone needed for augmenting your unique defect. But rest assured, effective bone grafting options exist to restore bone volume so dental implants can succeed.
Selection of the most suitable bone graft material tailored to your individual requirements will ensure a solid foundation for successful dental implant placement.