Osseous Regeneration Flashcards
what are the objectives of bone replacement grafting
- regeneration of lost periodontium - new bone, cementum, and PDL
- reduce or eliminate the periodontal pocket
what are the types of bone replacement grafts
- autograft
- allograft
- alloplast
- xenograft
- composite
what is an autograft
tissue transferred from one site to another in the same individual
what is an allograft
tissue transferred between individuals of same species
what is an alloplast
inert material used for graft
what is a xenograft
tissue transferred between individuals of differing species
what is a composite graft
combination of grafts
what are the indications for grafting
- deep vertical defects
- esthetic considerations
- teeth critical to prosthesis
- when anatomy precludes other procedures
- guided tissue regeneration
what are the contraindications for grafting
- poor plaque control
- medically compromised
- poor maintenance compliance
what are the advantages of grafting
- restores lost periodontal tissue
- maintains teeth in healthy functional state
- enhances long term prognosis of teeth
what are the disadvantages of grafting
- technique and material sensitive
- expensive
- may require two surgeries
- unpredictable
- requires ideal wound closure
- longer, more frequent post op care needed
- second surgical site sometimes required
- success decreases significantly in furcations and is defect dependent
what are the biologic responses for bone replacement grafts
- osteogenic
- osteoconductive
- osteoinductive
- osteoproductive
what is an osteogenic repsonse
viable osteoblasts are transplanted
what is a osteoconductive response
scaffold for bone formation
what is an osteoinductive response
release of material to induce bone formation
what is an osteoproductive repsonse
production of bone by a biologic mechanism
what is the healing sequence of bone replacement grafts
- incorporation (clot formation)
- revascularization
- resorption of graft material with release of factors (BMP) to induce bone formation
- bone formation
- bone remodeling and maturation
how do you tell if the defect will be a vertical defect
- amount of cancellous bone present
- if the distance between the roots of the teeth is greater than or 2.5mm then the defects will be a vertical defect