Bone biology, harvesting and grafting for dental implants

  • A.K. Garg
UK: Quintessence price £96, pp 279 ISBN 0867154411 | ISBN: 0-867-15441-1

This text presents a comprehensive review of techniques for improving bone volume for dental implants. The text is divided into four sections, namely, bone biology, bone harvesting, bone grafting and future directions. Each chapter is beautifully illustrated with high calibre clinical photographs and line drawings throughout. At the end of each chapter, there is a summary of chapter content and concluding remarks. In addition to the author presenting his own operative preferences, the scientific literature is extensively cited.

The first chapter gives an overview of bone biology and its role in the osseointegration process prior to description of bone grafting techniques. In the second chapter, a thorough overview of graft materials and techniques is presented. This includes specific clinical indications for use of autogenous bone grafts, allografts and xenograft materials. Chapter 3 covers guided bone regeneration techniques, and research studies are comprehensively cited to support the text. Chapters 4 to 7 deal with alveolar ridge preservation and bone harvesting techniques from the ramus and symphysis of the mandible, and the tibia. In addition to a comprehensive description of the clinical procedures, the author also deals with the possible complications. Interestingly, the author does not cover harvesting of bone from the iliac crest in detail; this may be a reflection of his own preference based on clinical experience. Management of the host sites in the anterior and posterior maxilla is discussed in Chapters 8-11. Finally, Chapter 11 presents possible future directions in bone biology and grafting. This includes the use of Growth Factors and gene therapy to regenerate bone. The reader is left feeling that there are exciting times ahead if the in vitro and animal studies can be replicated in vivo.

The case photographs are predominantly of surgical procedures, and it is difficult to appreciate the impact on the cosmetic side of the procedures described. Given my background as a prosthodontist, it would have been nice to see more clinical cases taken from pre-treatment, through the surgical phase and on to the final restorations. This would have enhanced the excellence of the text still further in my opinion. Further discussion of the management of soft tissues in conjunction with bone grafting would also have been helpful.

This text is ideally suited for surgeons and restorative dentists whose clinical practice is largely confined to the provision of implant dentistry. It would also be an excellent reference text for postgraduate trainees/students who are likely to be heavily involved in the provision of implant retained prostheses in the future.