Purpose
AAOMS states that the goal of grafting is to provide good quantity and quality of bone where the implant will go.1 The AAP lists periodontal disease, wearing dentures, developmental defects and injury as causes of too little bone for implants.2
Graft materials
AAOMS defines a bone graft as bone taken from the patient, from a human or animal donor, or made from synthetic materials.1
| Type | Source | Notes from AAOMS |
|---|---|---|
| Autograft | The patient's own bone | Needs a second site to collect the bone1 |
| Allograft | Human donor tissue | Screened and treated to reduce disease transfer1 |
| Xenograft | Animal-derived tissue | Screened and treated for safety1 |
| Synthetic | Manufactured material | Tissue growth may be less predictable1 |
AAOMS names the jaw, hip, lower leg, ribs and skull as sources of a patient's own bone.1
Ridge augmentation
Ridge augmentation (ridge modification) rebuilds a jaw ridge that has too little bone for implants.2 The AAP describes lifting the gum, filling the defect with bone or bone substitute and closing the site.2 The bone usually develops for 4 to 12 months before implants are placed.2 In some cases the implant is placed at the same time as the graft.2
What the research shows
A meta-analysis of 40 clinical studies assessed grafting to widen the ridge.3
| Approach | Result |
|---|---|
| Staged (graft first, implant later) | Mean width gain 3.90 mm |
| Simultaneous (graft with the implant) | Mean defect height reduction 4.28 mm |
| Implants in grafted bone | Survival and success above 95 percent |
Combining graft material with a barrier membrane gave better results in the simultaneous approach.3 Sites where the graft stayed covered by gum gained more bone than sites where it was exposed.3
Related procedures
- Socket preservation. Grafting at the time a tooth is removed.4
- Sinus lift. Grafting under the sinus floor in the upper back jaw.5
- Short implants. An option in some cases with limited bone height.6
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- AAOMS (MyOMS.org): Bone Grafting. myoms.org
- American Academy of Periodontology: Ridge Modification. perio.org
- Sanz-Sanchez I et al. Effectiveness of lateral bone augmentation on the alveolar crest dimension: systematic review and meta-analysis. J Dent Res 2015. pubmed.ncbi.nlm.nih.gov
- Avila-Ortiz G et al. Alveolar ridge preservation: systematic review and meta-analysis. J Clin Periodontol 2019. pubmed.ncbi.nlm.nih.gov
- American Academy of Periodontology: Sinus Augmentation. perio.org
- Jung RE et al. Group 1 ITI Consensus Report: implant length, design and medications. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
