GTR- Osseous Grafts

Question 1

Do you need a blood supply for bone regeneration?

Answer 1

Yes!

Question 2

How do we get a blood supply for bone regeneration?

Answer 2

Cortical perforation

Question 3

Biologic Requirements for Bone Regeneration

Answer 3

• Blood supply
• Stabilization
• Osteoblasts
• Confined space
• Space maintenance
• Wound coverage

Question 4

Bone forms by osteoblast migration from the defect margins, and is a scaffold for bone growth.

Neither inhibits nor induces bone formation.

Answer 4

Osteoconduction

Question 5

New bone formation through stimulation of osteoprogenitors to differentiate into osteoblasts.

Answer 5

Osteoinduction

Question 6

When bone cells migrate from the bone margin.

Answer 6

Osteoconduction

Question 7

When bone is made.

Answer 7

Osteogenesis

Question 8

The only graft material that’s osteoconductive, osteoinductive, AND osteogenic.

Answer 8

Autograft

Question 9

All graft materials are what?

Answer 9

OsteoCONDUCTIVE

Question 10

Advantage of using an alloplast.

Answer 10

Less risk of infectious disease.

Cheaper.

Question 11

Graft that’s widely used to treat infrabony defects.

Answer 11

Autografts

Question 12

Why do we prefer to use cortical bone as a bone graft?

Answer 12

1) Has less antigens when it’s freeze-dried.

2) Has more BMPs

Question 13

A mixture of bone dust and blood

Answer 13

Osseous coagulum

Question 14

Disadvantage of osseous coagulum

Answer 14

Inadequate amounts for large defects.

Question 15

Where does intraoral cancellous bone come from?

Answer 15

1) Maxillary tuberosity
2) Edentulous area
3) Healing socket

Question 16

Extraoral graft site that’s an autograft?

Answer 16

Anterior Iliac Crest

Question 17

Why is grafting from the hip not recommended?

Answer 17

Morbidity of the donor site.

Question 18

Risk of transmitting these diseases from an allograft.

Answer 18

1) Hepatitis
2) HIV
3) Prion Disease (Mad Cow Disease)

Question 19

What’s the best graft material for intraosseous defects?

Answer 19

Demineralized Freeze-dried bone allografts.

Question 20

Is DFDBA osteoinductive or conductive?

Answer 20

INDUCTIVE!

Question 21

What is the particle size that’s critical for neovascularization and ingrowth of bone?

Answer 21

100 - 1000 mm

Question 22

Processing that inactivates HIV.

Answer 22

• Freeze drying
• Alcohol Wash
• Acid demineralization

Question 23

What type of infection is NOT eliminated by autoclaving or heat sterilization?

Answer 23

Prion disease

Question 24

Alloplastic materials include what?

Answer 24

Calcium Phosphate and Sulfate

Question 25

Why do you do a sucular incision when placing a bone graft?

Answer 25

BC you want primary closure.

Question 26

Most common osseous defect seen interproximally.

Answer 26

2-walled

Question 27

After placing a graft, when is the only time you do surgical re-entry?

Answer 27

If you’re doing research and you want to measure bone fill.

Question 28

You hope to get trabeculation into the graft material in how long?

Answer 28

1 year

Question 29

What do barrier membranes separate?

Answer 29

PDL and bone from gingival epithelium and CT.

Question 30

Only these cells can regenerate the attachment apparatus.

Answer 30

PDL and Osteoblasts

Question 31

Indications for GTR

Answer 31

1) Class II furcations

2) 2 or 3-walled infrabony defects (including circumferential 2-wall defects).