Different sources and forms of

autogenous bone grafts and their

indications in preprosthetic
surgery

OSRG 421 ASSIGNMENT

Presented To: Dr Yehya Mehallawy
Presented By: Rouba Al Hamad
ID: 202100819
 ➢ Autogenous bone grafts are widely used in surgical procedures such as
preprosthetic surgery. These grafts come from the patient's own body.
These grafts provide a reliable and efficient method of supporting dental
implants or other prosthetic devices while also fostering bone development.
Autogenous bone grafts exist in a range of shapes and sizes, each with its
own set of applications.

➢ The physiologic features of autogenous bone graft have defined the "gold
standard" for bone grafting, and the efficacy of bone graft alternatives is
therefore compared to the known results of grafting bone defects with
autogenous bone.

ADVANTAGES OF AUTOGENOUS BONE GRAFTS:

- Provide appropriate quantity and good quality bone, including living stem cells,
growth factors, and osteoblasts.
- Autogenous bone transplants have a high success rate and long-term stability
when performed properly.
- They are biocompatible and promote natural bone repair.
- Reduce the chance of disease transmission
- Their osteogenic, osteointroductive, and osteoconductive capabilities promote
good bone repair and integration.

DISATVANTAGES OF AUTOGENOUS BONE GRAFTS:

-Harvesting bone from the patient's own body necessitates another surgical site,
which might result in more pain and a longer healing time.
-A limited quantity of suitable donor bone, particularly when significant quantities
are required.
INDICATIONS OF AUTOGENOUS BONE GRAFTS:

1. Sinus lift procedures

A sinus lift treatment involves raising the sinus floor to make room for bone
grafting in order to support dental implants.

2. Preservation of sockets
The procedure of adding bone to a tooth socket following extraction to
prevent bone loss and maintain shape is known as socket preservation or
alveolar ridge maintenance.

3. Augmentation of the alveolar ridge

In alveolar ridge augmentation, autogenous bone grafts are routinely utilized
to raise the height or width of the jaw bone to accommodate dental implants.

4. Two walled and three walled intra bony defect

5. Grade II, III Furcation involvement

6. Regeneration around implants

7. Filling donor side bone defects

SOURCES OF AUTOGENOUS BONE GRAFT:

Autogenous bone grafts can be obtained from a variety of sources within the
patient's body. The iliac crest, tibia, mandibular ramus, and calvarium are among
these sources. Each source has its own distinct properties and applicability for
certain therapeutic settings.

Intraoral sources

i. Mandibular symphysis: intraoral donor site and is in proximity to the

recipient site as well of its availability of sufficient bone volume
ii. Ramus: provides dense bone structure suitable for grafting in preprosthetic
surgery
 iii. Maxillary tuberosity: source of autogenous bone grafts especially in
maxillofacial reconstruction
iv. Healing extraction wounds
v. Bone from edentulous ridges
vi. Bone trephined from the jaw without damaging the roots
vii. Bone removed during osteoplasty or ostectomy
viii. Mental and mandibular retromolar areas
ix. Exostoses

Extra oral sources:

i. Iliac crest: ample supply of cancellous and cortical bone

ii. Calvarium: large quantities of cortical bone, suitable for craniofacial
applications
iii. Tibia: used in lower extremity reconstructive surgeries
iv. Rib: reconstructive procedures involving the chest wall, spine or nose
v. Hip marrow grafts
vi. Gerdi’s tubercle

FORMS OF AUTOGENOUS BONE GRAFTS

1. Cortical autografts: these grafts consist of the outer layer of the bone and
provide structural support

2. Cancellous autografts: these grafts contain the spongy inner layer of the
bone and promote new bone formation.

3. Cortico-cancellous autografts: these grafts combine both cortical and

cancellous bone, offering structural support and promoting new bone growth

4. Free bone grafts: these grafts are harvested as complete bone segments and
transferred to the recipient site.
SELECTING THE RIGHT AUTOGENOUS BONE GRAFT:

I. Specific Factors: Consider the patient's medical history, bone quality, and
donor sites that are available.
II. Surgery Requirements: Determine the volume and shape of the defect and
select the graft type that best meets the reconstructive requirements.
III. Experience of the Surgeon: Consider the surgeon's knowledge and
experience with a specific graft procedure.

References:

✓ Schmidt AH. Autologous bone graft: Is it still the gold standard? Injury.
2021 Jun;52 Suppl 2:S18-S22. doi: 10.1016/j.injury.2021.01.043. Epub 2021
Feb 3. PMID: 33563416.
✓ Kumar P, Vinitha B, Fathima G. Bone grafts in dentistry. J Pharm Bioallied
Sci. 2013 Jun;5(Suppl 1):S125-7. doi: 10.4103/0975-7406.113312. PMID:
23946565; PMCID: PMC3722694.