Dental Care

Bone Grafts for Dental Implants

When do you need bone grafts for dental implants? Dental implants are able to help a significant number of patients.  However, this helpful restorative technique requires enough bone in the jaw to permit secure placement of the implants. 

Unfortunately, some patients have lost bone volume due to periodontal disease, trauma, developmental defects or even ill-fitting dentures. 

In the past, many of these patients would have been eliminated as candidates for dental implants due to the insufficient volume of bone in the area.  Fortunately, modern dentistry's arsenal of weapons now includes the ability to augment existing bone by means of dental bone grafting procedures, enabling many more patients to be considered for dental implants.

When a dental implant would benefit a patient but bone volume is insufficient to permit a secure placement, bone grafting can augment the site's existing bone. 

Typically, bone augmentation involves grafting bone or a bone-like synthetic material to the patient's existing bone.  Over the course of several months to a year, the grafted bone or synthetic material fuses with the existing bone.  Once fusion has occurred, the dental implant can be put into place.

All dental bone grafts are classified into one of three types based on the source and type of material to be grafted onto the patient's existing bone.  These categories are called autogenous grafts (sometimes referred to as autografts), allografts and xenografts, respectively. 

Each type of grafting involves a surgical procedure and has its own benefits and disadvantages.  In fact, the first type, the autogenous grafting procedure, requires not one but two distinct surgical sites.

Autogenous Bone Grafts

Using autogenous bone grafts for dental implants involves harvesting the patient's own bone during a surgical procedure (hence the first surgical site) and then grafting it onto the appropriate site in that same patient's jaw (the second surgical site). 

The patient's own bone is generally considered the best material for dental bone grafts, and this type of procedure usually produces the best results. 

Autogenic dental bone grafts are considered "the gold standard" of bone grafts for dental implants because their results are the most predictable.  The bone used in this grafting procedure is live bone and contains active cellular elements that facilitate bone growth and fusion of the graft onto the existing bone. 

The grafted materials used in the other two types of bone grafts do not contain any of this live, active cellular material.  Moreover, because the patient's own bone is used as the grafting material in an autogenous graft, there is essentially no risk of tissue rejection or disease transmission. 

The bone is typically harvested from the patient's chin or the back part of the lower jaw, although some cases require the bone to be taken from elsewhere on the patient's body, such as the hip or tibia bone.  Because bone is removed from the donor site, some pain in that area is to be expected.

Allograft Bone Grafts

In contrast, allografts bone grafts for dental implants utilize either a synthetic bone-like material or bone taken from an unrelated person, almost always a cadaver.  Freeze-dried cortical cadaver bone specifically prepared for dental bone grafts has been proven to be extremely effective. 

The grafted cadaver bone promotes the growth of the patient's own bone into the future site of the dental implant. 

If synthetic grafting materials are used instead of cadaver bone, they utilize factors present within the patient's own blood to stimulate bone formation in the region of the future dental implant.

Xenograft Bone Grafts

Xenograft bone grafts for dental implants, on the other hand, contain bone that has been harvested from a completely different species, often a cow.  Xenografts typically work by means of one of two processes: 

osteoconduction (where new bone is formed from the patient's own cells along a framework of a compatible organic material) or osteoinduction (where new bone is formed through a biomechanical differentiation of the patient's own mesenchymal cells). 

Osteoinduction creates rapid bone development and is facilitated by a substance called Bone Morphogenic Protein, or BMP.

Best Bone Grafts

As mentioned above, autogenous bone grafts for dental implants provides the best chance of success. 

If you decide to have this type of bone grafts for dental implants to facilitate the future placement of a dental implant, the necessary bone will probably be taken from your chin or the back part of your lower jaw. 

However, if your surgeon is unable to harvest enough bone from one of these regions, a hip or shin bone (tibia) might be used as the donor site. 

The bones in these areas contain ample amounts of marrow, which contains the bone-forming cells necessary for the ultimate success of your bone graft.


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