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Wednesday, December 11, 2013
Face and Jaw Surgery
What are acceptable bone graft materials?
I need an implant for tooth #9, upper front left incisor, with a bone graft. One prosthodontist suggested an autogenous bone (AB)graft. An oral surgeon (independent) said he would not use AB because of resorption, and wanted to use demineralized bovine bone (DBB). I rejected DBB, because I don`t believe the risk assessment. He then suggested tricalcium phosphate (TCP). But TCP is also resorbable. He said synthetic HA is not used in modern implant dentistry. Is this true? Is TCP acceptable for the esthetic zone? How would you rank these materials?
Different practitioners have different outcomes and preferences for different socket preservation techniques and materials. One is not necessarily better than the other. The amount of bone required, the type of defect and need for esthetics are all considerations. Both autogenous bone and demineralized bovine bone matrix are successful in bone restoration in the anterior maxilla. Hydroxyapatite has fallen out of favor due to a variety of reasons. The best material is what your surgeon can predictably get a result with. That may vary dependent on technique and user preference.
Deepak Krishnan, DDS
Assistant Professor of Clinical Surgery
College of Medicine
University of Cincinnati