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Bone grafting techniques and materials for implant dentistry

Abstract

Bone quality, volume, height and width all play a pivotal role in dental implant stability, success and survival. A lack of adequate bone can be overcome with various bone grafting procedures. Dependent on many factors, including the amount of bone required, the site of implant placement, patient preferences and clinician factors; the type of bone grafting material and procedure undertaken can vary. Supplemental bone can be sourced from a variety of sources, including autogenous, allogenous and xenograft bone. Dependent on the source of the bone, it will have different properties in aiding bone formation, as well as being presented in different formulations, such as bone particles or bone blocks.

The aim of this paper is to provide an overview of bone grafting indications, materials and types of bone grafting techniques that can be utilised to aid dental implant provision. It also discusses the properties needed to ensure optimal success of guided bone regeneration techniques.

Key points

  • Provides an overview of bone grafting indications, materials and types of bone grafting.

  • Provides an overview of bone grafting properties to aid clinicians in the use of different materials, including donor bone and guided bone regeneration membranes.

  • Discusses bone grafting procedures that may be utilised in implant provision, including socket preservation and sinus augmentation.

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References

  1. Klein M, Al-Nawas B. For which clinical indications in dental implantology is the use of bone substitute materials scientifically substantiated. Eur J Oral Implant 2011; 4: 11-29.

  2. Wang H-L, Kiyonobu K, Neiva R F. Socket augmentation: rationale and technique. Implant Dent 2004; 13: 286-296.

  3. Kolk A, Handschel J, Drescher W et al. Current trends and future perspectives of bone substitute materials - from space holders to innovative biomaterials. J Craniomaxillofac Surg 2012; 40: 706-718.

  4. Feinberg S, Fonseca R. Biologic aspects of transplantation of grafts. In Fonseca R J, Davis W H (eds) Reconstructive Preprosthetic Oral and Maxillofacial Surgery. Philadelphia: Saunders, 1986.

  5. McAllister B S, Haghighat K. Bone augmentation techniques. J Periodontol 2007; 78: 377-396.

  6. Tomlin E M, Nelson S J, Rossmann J A. Ridge preservation for implant therapy: a review of the literature. Open Dent J 2014; 8: 66-76.

  7. Murugan R, Rao K P, Kumar T S. Heat-deproteinated xenogeneic bone from slaughterhouse waste: Physico-chemical properties. Bull Mater Sci 2003; 26: 523-528.

  8. Simunek A, Cierny M, Kopecka D, Kohout A, Bukac J, Vahalova D. The sinus lift with phycogenic bone substitute. A histomorphometric study. Clin Oral Implants Res 2005; 16: 342-348.

  9. Buser D, Martin W, Belser U C. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants 2004; 19: 43-61.

  10. Gastaldo J F, Cury P R, Sendyk W R. Effect of the vertical and horizontal distances between adjacent implants and between a tooth and an implant on the incidence of interproximal papilla. J Periodontol 2004; 75: 1242-1246.

  11. Tarnow D P, Cho S C, Wallace S S. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol 2000; 71: 546-549.

  12. Howe M S, Keys W, Richards D. Long-term (10-year) dental implant survival: A systematic review and sensitivity meta-analysis. J Dent 2019; 84: 9-21.

  13. Khairnar M S, Khairnar D, Bakshi K. Modified ridge splitting and bone expansion osteotomy for placement of dental implant in esthetic zone. Contemp Clin Dent 2014; 5: 110-114.

  14. Horváth A, Mardas N, Mezzomo L A, Needleman I G, Donos N. Alveolar ridge preservation. A systematic review. Clin Oral Investig 2013; 17: 341-363.

  15. Berglundh T, Armitage G, Araujo M G et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018; 89: 313-318.

  16. Schwarz F, Bieling K, Latz T, Nuesry E, Becker J. Healing of intrabony peri-implantitis defects following application of a nanocrystalline hydroxyapatite (Ostim) or a bovine-derived xenograft (Bio-Oss) in combination with a collagen membrane (Bio-Gide). A case series. J Clin Periodontol 2006; 33: 491-499.

  17. Jensen S S, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. Int J Oral Maxillofac Implants 2009; 24: 218-236.

  18. Smiler D, Soltan M. The bone-grafting decision tree: a systematic methodology for achieving new bone. Implant Dent 2006; 15: 122-128.

  19. Brånemark P I. Capillary form and function. The microcirculation of granulation tissue. Bibl Anat 1965; 7: 9-28.

  20. Elgali I, Omar O, Dahlin C, Thomsen P. Guided bone regeneration: materials and biological mechanisms revisited. Eur J Oral Sci 2017; 125: 315-337.

  21. Lee S-W, Kim S-G. Membranes for the Guided Bone Regeneration. Maxillofac Plast Reconstr Surg 2014; 36: 239-246.

  22. Aprile P, Letourneur D, Simon-Yarza T. Membranes for Guided Bone Regeneration: A Road from Bench to Bedside. Adv Healthc Mater 2020; 9: 2000707.

  23. Zitzmann N U, Naef R, Schärer P. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int J Oral Maxillofac Implants 1997; 12: 844-852.

  24. Eskan M A, Girouard M-E, Morton D, Greenwell H. The effect of membrane exposure on lateral ridge augmentation: a case-controlled study. Int J Implant Dent 2017; 3: 26.

  25. Souza S L, Novaes Jr A B, Pontes C C, Taba Jr M, Grisi M F, Silveira e Souza A M. Guided bone regeneration with intentionally exposed membranes and its implications for implant d. J Osseointegration 2010; 2: 45-51.

  26. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 2003; 23: 313-323.

  27. Helmy M A. Review of socket preservation technique. EC Dent Sci 2017; 14: 7-14.

  28. Hong B, Bulsara Y, Gorecki P, Dietrich T. Minimally invasive vertical versus conventional tooth extraction. J Am Dent Assoc 2018; 149: 688-695.

  29. Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hürzeler M B. Bone loss after full-thickness and partial-thickness flap elevation: Bone loss after flap elevation. J Clin Periodontol 2011; 38: 157-162.

  30. Garcia J, Dodge A, Luepke P, Wang H-L, Kapila Y, Lin G-H. Effect of membrane exposure on guided bone regeneration: A systematic review and meta-analysis. Clin Oral Implants Res 2018; 29: 328-338.

  31. Caudry S, Landzberg M. Lateral window sinus elevation technique: managing challenges and complications. J Can Dent Assoc 2013; 79: 101.

  32. Zaniol T, Zaniol A. A Rational Approach to Sinus Augmentation: The Low Window Sinus Lift. Case Rep Dent 2017; 2017: 7610607.

  33. Pontes F S, Zuza E P, de Toledo B E. Summers' technique modification for sinus floor elevation using a connective tissue graft. A case report. J Int Acad Periodontol 2010; 12: 27-30.

  34. Rosen P S, Summers R, Mellado J R et al. The bone-added osteotome sinus floor elevation technique: multicentre retrospective report of consecutively treated patients. Int J Oral Maxillofac Implants 1999; 14: 853-858.

  35. Starch-Jensen T, Mordenfeld A, Becktor J P, Jensen S S. Maxillary Sinus Floor Augmentation With Synthetic Bone Substitutes Compared With Other Grafting Materials: A Systematic Review and Meta-analysis. Implant Dent 2018; 27: 363-374.

  36. Sáez-Alcaide L M, Brinkmann J C-B, Sánchez-Labrador L, Pérez-González F, Molinero-Mourelle P, López-Quiles J. Effectiveness of the bone ring technique and simultaneous implant placement for vertical ridge augmentation: a systematic review. Int J Implant Dent 2020; 6: 82.

  37. Miller R J, Korn R J, Miller R J. Indications for Simultaneous Implantation and Bone Augmentation Using the Allograft Bone Ring Technique. Int J Periodontics Restorative Dent 2020; 40: 345-352.

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Sunmeet Kandhari, Sehrish Khalid, Alistair James and Dominic Laverty were all involved in the preparation and review of this manuscript.

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Correspondence to Sunmeet Kandhari.

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The authors have no conflicts of interests to declare.

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Kandhari, S., Khalid, S., James, A. et al. Bone grafting techniques and materials for implant dentistry. Br Dent J 235, 180–189 (2023). https://doi.org/10.1038/s41415-023-6113-1

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