Autogenous Block Bone Grafting for Implants
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There are times when composite materials such as bovine bone (BioOss) can simply not provide enough bulk or adequately replace the amount of bone that has been lost after tooth extraction. In these cases it is sometimes necessary to revert to harvesting the patient’s native bone to achieve a “live bone” replacement of the deficient area. Possible causes of bone loss that produce defects significant enough to warrant the need for this approach include:
- Extractions where immediate implant replacement or grafting was not provided
- Sites where the missing tooth was associated with a bone destructive disease (i.e., infection, cysts, tumors)
- Areas of congenitally missing permanent teeth where normal bone volume failed to develop
- Bone lost from dental trauma
In cases such as this, the most commonly used grafting procedure is autogenous (harvested from the patient) and is placed in the form of a block.
The procedure involves removing a small block of bone (approx. 1 cm square) from the mandibular ramus or chin and transferring that bone to the area of bone deficiency. The graft is then secured with one or two tiny screws and overlaid with particulate bovine bone and a collagen membrane. The surgical site is securely closed and four months is usually given for the graft to fuse to the underlying jawbone before re-entry to place an implant.