What is a dental bone graft?
Dental bone grafting is a treatment used in dentistry when the placement of an implant is compromised. It increases the size of an area of the maxilla or mandible, it can also correct defects or improve the quality of the area to receive a future implant. In this way it becomes an alternative treatment for patients with little bone or defective bone.
When is bone grafting necessary and am I a candidate?
Bone grafting is performed when the patient does not have the ideal support or dimensions to completely cover a dental implant. Placing an implant in a patient with deficient bone would only cause the mobility of the implant and therefore the failure of the treatment.
The bone to be grafted can be obtained from the patient himself, normally from the mandible, the skull or the iliac crest, or a donor bone graft (human or animal) can be used. Grafts can be of different types, the most common being:
- Particulated dental bone graft and/or with guided bone surgery.
- Elevation in the maxillary sinus.
Dental bone graft in block.
During the intervention the specialist will make an incision in the area where the graft is to be made, lifting and separating the gum. Then he will place the chosen bone graft, then the area will be covered with a membrane that will allow the graft not to be lost and the gum will be sewn so that saliva and food does not invade the area.
The integration of the dental bone graft depends on the type of bone used and the size of the defect to be treated. Normally the period for the graft to fully integrate is about three to four months. If the bone used is synthetic or of animal origin the time can be longer, about six months. Sometimes the desired success is not obtained with the placement of a graft, the body can reabsorb more than desired, thus requiring a second graft placement months later.
How many types of bone grafts are there?
- Autologous graft
These are the so-called ‘autografts’: those taken from a donor area of the patient. They allow transplants of living cells, with these there is no immunological rejection, since the grafted material comes from the individual himself.
- Homologous grafts or allografts
These are performed between individuals of the same species, but genetically different, taken from donors in tissue banks. Bone banks make it possible to have an unlimited amount of bone available without the inconvenience of harvesting it. There is a risk -although minimal- of disease transmission to allograft recipients, the higher the prestige of the bank or brand of the graft, the possibilities of transmission are almost nil.
Allografts have a number of advantages over autologous grafts: they have immediate availability and the option of obtaining different sizes, shapes and adequate quantity, they avoid post-operative discomfort at the donor site and can be stored for long periods of time.
- Heterologous grafts or xenografts
These are grafts between individuals of different species, in which their materials are derived from three different species: algae, animals and coral.
They are considered risk-free and easy to obtain. The most representative are chemically treated deproteinized bovine bone.
- Alloplastic materials or grafts
They do not come from organic individuals, being manufactured through artificial processes that arise as a solution to avoid possible complications generated by allografts and xenografts.
Those containing pores are the perfect ones to accommodate bone development. The most commercialized are bioactive crystals, including tricalcium beta-phosphate and hydroxyapatite.
Bone grafts, whether biomaterials or not, are essential in the rehabilitation treatment with dental implants in edentulous areas with bone loss or defects.
After the procedure it is important to keep the graft in position, several postoperative instructions will be explained, one of the most important is a special diet and rest. During the first moments of healing of the graft material, there is a competition between bone and soft tissue to fill the cavity and the soft tissue proliferates faster tending to close the cavity.
How do we regenerate and make the treatment more effective?
Guided Bone Regeneration (GBR) is based on the formation of new bone for the filling of large bone defects; it involves the use of membranes with barrier functions suitable to prevent infiltration or displacement of the grafted bone particles in the repair area.
The development of guided bone regeneration membranes has demonstrated their usefulness in assisting and aiding in bone grafting. They help in preventing other tissues from invading the bone clot and interfering with bone regeneration.
What is Fibrin Rich Plasma and how does it help in this treatment?
Fibrin Rich Plasma or better known as (PRF) was defined in France and is recognized as a second generation of regeneration with which a higher concentration of platelets is obtained from the patient’s blood.
Platelet-rich fibrin provides fibrin rich in growth factors, which promotes and accelerates the repair of soft and hard tissues.
PRF is obtained by centrifuging a sample of the patient’s blood. This centrifugation technique has been used for many years to obtain platelet-rich plasma (PRF), but until recently the reparative potential of the fibrin obtained in the first centrifugation cycle was not known or, rather, was not exploited.
PRF is a powerful regenerative biomaterial used in the treatment of periodontal intraosseous defects, which is part of our state-of-the-art treatments we have for you.
In Makeover Dental Studio we carry out the most advanced techniques on bone grafting performed by the specialist in the area Dr. Rafael Cortes Alvarez. If you need an evaluation, schedule your appointment at makeoverdentalstudio@hotmail.com or call us at MX (664)634-2023 / EU (619) 202-0423.
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Information obtained in part from:
Effectiveness of fibrin-rich plasma and collagen membrane in guided bone regeneration from Rev. Clin. Periodontics Implantol. Periodontics Implantol. Oral vol.12 no.2 Santiago Aug. 2019.
Different bone filler alternatives. Advances in Periodontology vol.24 no.3 Madrid Dec. 2012.