Bone grafting refers to the application of various materials to a bone defect to restore form or function. In oral surgery, the simplest bone grafting procedures are performed to maintain a good volume of healthy bone so that a tooth removal site will optimally heal and a dental implant can be successfully placed and maintained.
Bone grafting procedures are also used to create new bone in areas where bone has been lost or is lacking, so that dental rehabilitation can be completed. Bone graft materials used in these applications are usually either donor human bone or processed bovine (cow) bone, depending on the clinical situation. Both bone graft sources have been proven safe and effective and have been used in surgery successfully for many years.
If bone grafting is more extensive than a single tooth site, additional biologic preparations may be added to the bone graft such as platelet rich fibrin, platelet rich plasma, or bone morphogenetic protein to enhance bone growth and long term graft stability.These more complex grafts may also require the use of containment systems consisting of collagen or Gortex membranes or titanium mesh. When a Gortex membrane or titanium mesh is used to contain a bone graft, the membrane or mesh often is removed once the bone graft is healed. The removal can be done at the time of dental implant placement, if that is part of the treatment plan.
Major bone defects in the facial skeleton that result from trauma, tumor removal or other disease processes often require the harvest of the patient’s own bone, combined with some of the materials mentioned above, to gain the best result. The bone graft donor sites can vary from different locations in the facial skeleton, or might include the Iliac crest (hip bone) which is an excellent source of bone forming cells and bone marrow. Generally, several months of healing are required for a major bone graft to become stable.