Bone graft materials
The following points should be considered by the dentist for bone grafting in lost tooth hole; 1) the space should be considered for inserting the bone graft so; the volume of the bone graft should be exactly the same as the main bone; 2) the bone should be dense enough to support dental implant in a stable way and bone graft should have the specifications of ossification to produce bone cells, and 3) the materials should be relatively cheap and available and free of pathological conditions.
Bone graft materials
The following points should be considered by the dentist for bone grafting in lost tooth hole; 1) the space should be considered for inserting the bone graft so; the volume of the bone graft should be exactly the same as the main bone; 2) the bone should be dense enough to support dental implant in a stable way and bone graft should have the specifications of ossification to produce bone cells, and 3) the materials should be relatively cheap and available and free of pathological conditions.
Mineralized bovine bone
Bones that are extracted form cow are considered as allograft. This bone is a apatite containing carbonate with a crystal like architecture and the ratio of calcium/phosphate in it is similar to the ratio of minerals in human bone. Over time, mineralized bovine bone graft is integrated and will be replaced by newly formed bone texture. Bovine graft will remain for 18 months. It takes 6 to 9 months before inserting the implant when bovine graft is used to fill the hole of the lost tooth. It is not suitable for when the dentist is eager to insert the implant immediately after pulling the tooth.
Mineralized bone auto graft
Human mineralized bone in particle form can preserve bone volume in lost tooth site and during preparation the site for inserting implant. Some of the advantages of auto grafts are as follows:
- This material is available without second surgery for up taking the bone
- This material creates bone and it is hoped that this material will be lost after a while and will be replaced by bone
Human mineralized bone is available in the form of membrane or sponge bone and recommended particle is about 350 to 500 micrometer. Smaller particles than 350 micrometer tend to follow out of the place by blood circulation and larger particles will not match the site due to their size. Auto grafts are provided by bone banks; they use sterile processes for taking bone and wash them thoroughly.
Self-generating bones
Doctors believe that the ideal material for bone graft substitution is self-generating bone. To graft the bone in lost tooth site; we can take the self-generating bone from pelvic bone or jaw bone or we can use the taken bones during alveoloplasty. The adjacent bone can be rasped by a drill and particles can be collected in a sieve. It is also possible to take a block of pelvic bone to use.
Taking self-generating bones should be decided before pulling the tooth. Cuttings should be planned based on tunneling under periosteum or separate cuts for taking bones. When more than one tooth is pulled out; we can have alveoloplasty to insert particles of bones in the lost tooth site. One of the methods other than using alveoloplasty bone is using tunneling under periosteum and drills to collect bone particles from an external oblique groove. The other method is using a sieve that is inserted in suction pipe for collecting bone particles. For collecting bone particles; we can also use implant preparation drills or a rounded head drill to collect bone particles from pelvic bone.
Clinical studies and case reports have shown that self-generating bone graft method has greater final results and more successful ones in comparison with other methods.
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