Bone Grafting and Dental Implantology Flashcards
Give the 4 causes of bone loss
Congenital e.g. Cleft palate
Traumatic e.g. injury
Pathology e.g. cancer/cysts/tumours and resection of pathology
Natural e.g. loss of bone over time , alveolar ridge becomes thinner , may get osteoporosis
What are the types of Bone graft?
Autogenous (from same individual)
- taken from Intra oral (chin, ramus, tuberosity, coronoid process
- Extra oral (Ilial osteum (hip), Calvarium)
Xenograft (from donor)
- Deproteinised bone matrix (Bio-Oss)
Allograft (same species but not genetically identical)
- Irradiated sterilised freeze dried bone blocks
Alloplastic
- Natural sources and synthetic materials
Bone bioengineering
- Growth factors like Bone Morphogenic Protein (BMP)
What are the principles of bone grafting?
Osteoconduction
- Concept of scaffold that supports bone forming cells
Osteoinduction
- Osteogenesis induced through recruitment of immature cells (UMC) for bone formation
How to chose what type of bone graft site?
- Adjacent structures e.g. mental foramen or IAN
- Pt preference
- Availability of bone depending on anatomy via CBCT
Describe the surgical procedure to harvest bone
- Harvest from odontogenous bone
- Expose bone by removing mucoperiosteum
- use precision cuts with surgical saw
- Metal and chisel to harvest only the outer cortex of bone
- Place into defect and hold in place with screws
- Score periosteum to allow tissues to reposition
- Place Bio-Oss and reposition tissues and suture
What are the principles of alveolar distraction osteogenesis?
- Osteotomy
- latency period for a week(wait for inflammation cells to come to site, ST will heal)
- Distraction via rod separation (chose vector, rate and rhythm) - approx 1mm a day (limit to this or wil cause fibrous tissue healing)
- Consolidation
- Remodelling
When are Zygomatic implants indicated?
- Severe maxillary atrophy
- Sinus pneumatisation
- Avoid harvesting of bone graft
- Hemimaxillectomy
