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Oral Surgery 2 > Principles of Bone Grafting > Flashcards

Principles of Bone Grafting Flashcards

1
Q

osteoinduction

A

new bone formation from differentiation of osteoprogenitor cells into osteoblasts

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2
Q

osteoprogenitor cells are derived from what cells?

A

mesenchymal

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3
Q

differentiation of osteoprogenitor cells are influenced by what?

A

bone inductive proteins from the bone matrix

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4
Q

what must be stimulated to differentiate into the osteoblasts by transplanted growth factors and cytokines?

A

host cells

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5
Q

what initiates osteoinduction?

A

BMP (bone morphogenic protien)

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6
Q

BMP (bone morphogenic protien) is a member of what?

A

cytokine family of growth factors

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7
Q

BMP (bone morphogenic protien) acts on what?

A

progenitor cells to induce differentiation into osteoblasts

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8
Q

BMP (bone morphogenic protien) is higher in what type of bone?

A

higher in cortical bone than cancellous

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9
Q

osteoconduction

A

formation of new bone from either host-derived or transplanted osteoprogenitor cells along a biologic frameowkr

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10
Q

osteoconduction provides what?

A

only passive framework or “scaffolding”

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11
Q

T/F: osteoconductive cells can produce bone

A

false, can’t… just conducts bone forming cells from host into/around the scaffolding

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12
Q

osteogenesis

A

formation of new bone from osteoprogenitor cells

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13
Q

osteogenesis have what type of properties?

A

osteoinductive and conductive

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14
Q

what type of graft posses osteogenesis, osteoconductive and osteoinductive properties?

A

autogenic grafts

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15
Q

phase 1 of two-phase theory of osteogenesis

A

transplanted cellular bone produces new osteoid

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16
Q

the amount of bone regenerated during phase 1 depends on what?

A

the amount of transplanted bone cells that survive

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17
Q

T/F: considerable amount of cell death occurs during grafting procedures and phase 1 may not lead to an impressive amount of regeneration

A

true

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18
Q

which phase determines the quantity of bone that the graft will form?

A

phase 1

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19
Q

cells in phase 1 is most active within what?

A

4 weeks

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20
Q

phase 2 of two-phase theory of osteogenesis

A

angiogenesis and fibroblastic proliferation from the graft bed begin after grafting, and osteogenesis from host connective tissue soon begins

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21
Q

initial woven bone in phase 2 is resorbed and replaced by what?

A

lamellar bone

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22
Q

as the initial graft is resorbed, what is released from the matrix?

A

bone morphogenic proteins (BMP)

23
Q

phase 2 determines what?

A

quality

24
Q

when does phase 2 begin and peak?

A

begins at 2 weeks and peaks around 6 weeks

25
Q

T/F: remodeling process continues indefinitely

A

true

26
Q

types of grafts

A
  1. autograft
  2. allograft
  3. xenograft
  4. alloplast
  5. recombinate graft
27
Q

what is the golden standard of grafts?

A

autografts

28
Q

which type of graft is most frequently used in OMFS?

A

autografts

29
Q

autografts

A

composed of tissues from the same individual

30
Q

T/F: autografts have osteogenic properties (possibly but not always)

A

true

31
Q

advantage of autografts

A

biocompatability

32
Q

disadvantage of autografts

A
  1. second surgical site
  2. requirement of anesthesia
  3. scarring
33
Q

source of autografts

A
  1. chin and other intraoral sites
  2. anterior iliac crest
  3. posterior iliac crest
  4. anterior tibia
  5. calvarium
  6. rib
  7. pedicle grafts
34
Q

which autograft sources may not have osteogenic potential if primarily cortical bone is harvested?

A
  1. chin and other intraoral sites
  2. calvarium
  3. rib
35
Q

what can be harvested with cartilage for TMJ reconstruction?

A

rib

36
Q

source of pedicle grafts

A
  1. fibula

2. radial forearm

37
Q

free flap is indicated when autografts are sourced from where?

A
  1. fibula
  2. radial forearm
  3. iliac
  4. scapula
38
Q

T/F: allografts/homografts are osteoconductive

A

true

39
Q

allografts/homografts are sourced from where?

A

cadaver bone

40
Q

allografts/homografts carries what?

A

inductive proteins in some cases

41
Q

allografts/homografts are replaced by what?

A

patient’s own bone

42
Q

advantages of allografts/homografts

A
  1. no donor site morbidity

2. readily available

43
Q

disadvantages of allografts/homografts

A
  1. no viable cells for phase 1 osteogenesis
  2. longer consolidation period
  3. encapsulation
  4. disease transmission
  5. graft/host reaction
  6. patient acceptance
44
Q

xenograft

A

grafts transplanted between individuals of different species

45
Q

T/F: xenografts are osteoconductive

A

true

46
Q

advantages of xenografts

A
  1. no donor site morbidity
  2. carrier for inductive proteins (possible)
  3. limitless quantity
47
Q

disadvantages of xenografts

A
  1. expensive
  2. longer consolidation period
  3. disease transmission
  4. patient acceptance
48
Q

recombinate grafts

A

recominate bone morphogenic proteins

49
Q

which recombinate BMPs are FDA approved?

A

BMP-2 and BMP-7

50
Q

BMP-2 has been approved for what?

A
  1. sinus floor augmentation

2. grafting of mandibular defects

51
Q

T/F: recominate grafts can be done in children/skeletally immature patients

A

false, it’s not

52
Q

disadvantage of recombinate graft

A
  1. expensive

2. may cause swelling, sterility, oncogenesis?

53
Q

common application of grafting in OMFS

A
  1. reconstruction of socket following tooth ext
  2. particulate grafting of small defects or sinus floor to improve implant site
  3. onlay grafting using intraoral donor for improving implant site
  4. onlay grafting with ICBG for larger defects to improve implant site
  5. grafting of alveolar cleft in children with cleft lip/palate
  6. grafting of facial contour defects associated with trauma
  7. costochondral grafting for replacement of TMJ
  8. grafting of continuity defects resulting from pathology or trauma

Oral Surgery 2 (13 decks)

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