Volume 2 - Issue 4 (Aug-Oct) Download Pdf - IJMD

Alloplastic Bo n e Gr a f t i n g Materialsreview articleAnurag Ashok Shendre*, Deepti Gattani @ , Arshad Sayed % , Narpat Singh Rajput ~ABSTRACTBone grafting has become a valuable mainstream clinical procedure in today’s dentistry in a variety of reconstructiveapplications. Various materials and formulations have been developed for this purpose. The synthetic bone graftsubstitutes as yet offer only a part solution to the management of localized bone loss. Ideally a synthetic bone graft substituteshould mimic the native bone in both mechanical and osteogenic properties. They possess some of the desiredmechanical qualities of bone as well as osteointegrative/conductive properties. It has given the clinicians the abilityto offer patients alternative treatment modalities that can serve to restore the missing bone anatomy. Present reviewdeals with the various alloplastic bone graft materials. Various advantages and disadvantages with these materials arediscussed.Key words: Reconstruction, Bone grafts, Osteointegration , Osteoconduction, OsteogenesisIntroductionBone grafting has become a valuable mainstreamclinical procedure in today’s dentistry in avariety of reconstructive applications. Ridgepreservation after tooth extraction is very importantfor making any kind of prosthesis, be it dentures, fixedbridge or implants. 1 Various materials and formulationshave been developed for this purpose. It has given theclinicians the ability to offer patients alternative treatmentmodalities that can serve to restore the missing boneanatomy for ridge maintenance or preservation, ridgeaugmentation and for enhanced bone foundation forendosseous implant placement and to fill in any bonydefects or voids such as caused by removal of a cyst ortumor. 2There are four characteristics that an ideal bone graftmaterial should exhibit which include: 61. Osteointegration, the ability to chemically bond to thesurface of bone without an intervening layer of fibroustissue.2. Osteoconduction, the ability to support the growth ofbone over its surface.3. Osteoinduction, the ability to induce differentiation ofpluripotential stem cells from surrounding tissue to anosteoblastic phenotype.*PG Student,@Professor,%Dean and Head , Dept of Periodontics, Swargiya DadasahebKalmegh Smruti Dental College and Hospital, Nagpur.~ Post Graduate, Dept of Periodontics. Sree Balaji Dental Collegeand Hospital, Bharath University, Pallikaranai, Chennai.Corresponding Author:Dr.Narpat Singh RajputE mail: narpat_singh_rajput@yahoo.co.in4. Osteogenesis, the formation of new bone by osteoblasticcells present within the graft material. Synthetic bonegraft substitutes currently possess only osteointegrativeand osteoconductive properties.The synthetic bone graft substitutes as yet offer onlya part solution to the management of localized boneloss. They possess some of the desired mechanicalqualities of bone as well as osteointegrative /conductive properties but are largely reliant onviable periosteum/bone for their success. Ideallya synthetic bone graft substitute should mimic thenative bone in both mechanical and osteogenicproperties.Classification of Bone Graft Materals 3(i) Autogenous bone grafts :They are osteogenic, osteoconductive and osteo inductive.There is no risk of host rejection or disease transmission.But its major disadvantages are procurement morbidity,limited availability and high cost. 4(ii) Allograft :It is nonvital , osseous tissue taken from one individualand transferred to another of the same species. Theyare osteoconductive and weakly osteoinductive. Itsadvantages include greater availability of bankedbone than autograft and no additional surgicalprocedure needed. Its disadvantages include riskof disease transfer, not osteogenic, immunogenic,variable clinical results and expensive. 5(iii) Xenogenic bone grafts :It is an osseous tissue that is harvested from onespecies, processed and then transferred to a recipientIndian Journal of Multidisciplinary Dentistry, Vol. 2, Issue 4, August-October 2012 573