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overview
What is Graft?
What is Grafting?
What are Bone Grafts?
Historical Review
Objectives & Rationale of Bone Grafts
Biologic concept of using Bone Grafts
Bone Grafts used in correction of
periodontal defects
Technique
What is graft
?
A viable tissue that after
removal from a donor site is
implanted with in a recipient
tissue is then restored repaired
& regenerated.
What is
grafting ?
What are bone
grafts?
Bone grafts are the
materials used for
replacement or
augmentation of the
Historical Review:
The use of bone grafts for
reconstructing osseous
defects produced by
periodontal disease dates
back to Hegedus in (1923 )
Stimulation of
osteoprogenitor cells
Osteoblasts
Forms new
centers of
ossification
within the graft
Bone Grafts used in
correction of
Periodontal Defects:
Autografts
Allografts /
Homografts
Xenografts /
Hetrografts
Alloplasts
Autografts: A tissue transferred
from one position to another within
the same individual .
Allografts / Homografts: Obtained
from genetically dissimilar individual
of same species .
Xenografts / Hetrografts: Tissue
transferred from one species to
another species.
Alloplasts: A synthetic graft or inert
foreign body implanted into tissue.
Autografts :
Widely used in periodontics
for treatment of intrabony
defects.
Promotes bone healing
through osteogenesis & / or
Osteoconduction.
Can be harvested from
either intraoral or extraoral
donor sites.
Autografts from
intraoral site
-Hegedus
Sources include: (1922)
Maxillary tuberosity
Mandibular
Exostoses symphysis
Osseous coagulum
Bone Blend
Intraoral Cancellous Bone
Marrow Transplants
Bone swaging
Osseous Coagulum:
-
•Technique uses (Robinson)
mixture of bone
dust & blood
•Small particles ground from cortical
bone used
ADVANTAGES:
* Additional surface area for
interaction of cellular & vascular
elements.
* Ease of obtaining bone
from already exposed surgical site.
DISADVANTAGES:
Bone Blend:
•Uses an autoclaved capsule &
pestle.
• Bone removed from
perdetermined site , triturated
in capsule to a workable ,
plastic like mass, & packed into
bony defects
Absorbable Nonabsorbable
materials
Ceramics, materials
Porous
Beta tricalcium hydroxyapatite
phosphate Dense
Hydroxyapatite hydroxyapatite
Calcium sulfate Bioglass
Calcium Calcium-coated
carbonate. polymer of
hydroxyethylmethac
Bioceramics: Composed of CaPO4
with Ca & Po4 ratio similar to
bone
Beta tricalcium phosphate:
Porous form of CaPo4
Hydroxyapetite:
Porous non resorbable
Solid non resorbable or
solid resorbable.
Polymers:
2 types
1) A non-resorbable ,
calcium hydroxide coated co-
polymer of poly - methyl –
methacrylate(PMMA).
2) Poly – hydroxylethyl
- methacrylate(PHEMA) / (HTR)
Hard tissue replacement.
Bioactive glass: CaO, Na2O,
SiO2,P2O5
Bonds to bone through
development of surface layer of
carbonated hydroxyapetite.
Bio glasses exposed to tissue
fluids….formation of double layer of
silica gel & calcium phosphate on
their surfaces….absorption &
concentration of proteins through
this layer….proteins used by
osteoblasts to form extracellular
bone matrix.
Technique
Patient
selection
Regional Anesthesia
for patients comfort
Local infilteration
with epinephrin to
facilitate hemostasis
Flap design
Post op
Pre op
Post op
Summa
Bone grafts are the material
ry
used for replacement or
augmentation of the bone around
the teeth.