With the introduction of advanced bone grafting techniques and the use of sophisticated bone replacement graft materials, it is possible to increase the volume, width, and height of bone in deficient areas to regenerate the tissues supporting questionable teeth and to permit the placement of implants in ideal positions and angulations, which will result in more acceptable and predictable restorations. (33)
The use of materials …show more content…
An osteogenic graft is derived from or composed of-tissue involved in the growth or repair of bone. Osteogenic cells can encourage bone formation in soft tissue (25) e.g. grafting autogenous bone or bone marrow. (36)
Osteocoduction defines bone formation by the procedure of ingrowth of capillaries and osteoprogenitor cells from the receiver bed into, round, and through a graft or bio implant. Thus, the graft or bioimplant acts as a support for new bone formation. Different osteoinduction, this procedure happens in an already bone containing environment. Osteoconduction defines the facilitation of bone growth along a support of autogenous, allogeneic or alloplastic material. (37)
Osteoinduction describes the process whereby original bone is formed in an area there was no bone before. One tissue or its derivative causes alternative undifferentiated tissue to differentiate into bone. The phenomenon of osteoinduction remained first described in the classic work of Urist. (38) Bone matrix was shown to induce bone formation within muscle pouches of many species of animals. Later, a specific excerpt from bone, a protein now mentioned as Bone Morphogenetic Protein (BMP), was recognized as that reason which produced the phenomenon. …show more content…
For many years, it has been the gold standard of bone replacement because it provides osteogenic cell as well as essential osteoinductive and osteoconductive elements for healing. In addition, it lacks immunological rejection mechanism or disease transmission. (40)
Autogenous bone can be obtained from various donor sites that may be extraoral or intraoral, depending on the volume and the type of bone required for restoration of the underlying defect. (41)
If large volume of bone is required, iliac crest or tibia is often selected, (42) as substation amount of spongy and cortical bone can be harvested. As a major disadvantage; grafting can only be performed under general anesthesia and hospitalization. (43) In addition to high cost, morbidity and post-operative pain at the donor sites are among the disadvantages. (44)
When a limited amount of graft material is required, it is possible to harvest bone from intra oral sites (retromolar area, maxillary tuberosites, exostoses or symphysis). (45,