Discussions on Bone Grafting

With all these other graft materials available, and their proven efficacy, is there still justification for creating a second surgical site to harvest an autogenous graft?

With the advent of MIAMBE (Minimally Invasive Antral Membrane Balloon Elevation), another technique is being used with success that offers advantages and disadvantages.

There has been considerable interest in using mesenchymal stem cells and pluripotent cells for bone
regeneration. This is especially important for use in stimulating bone regeneration in extractions sites.

I have a patient who will require bone augmentation of the alveolar ridge at the maxillary first molar site.

In my training, we were required to place membranes over every bone graft, but I have observed that some oral surgeons do not always use membranes to cover their bone grafts sites, and I have had many difficulties with membranes.

What is the best way to close a maxillary flap without tension over the alveolar ridge? I have had some trouble with large particulate bone grafts with titanium mesh or block grafts.

I have a patient with implant in #3 area. The zone of keratinized tissue following 2nd stage surgery is inadequate.

I would like to preserve this implant. Are there any kinds of bone grafting procedures and techniques that I could do to accomplish this?

Some experienced clinicians suggest the long term viability of the implant post block grafting is poor.

Considering there is no blood supply to the graft material early on, I believe the addition of antibiotics to the graft can be helpful to prevent infection of the bone graft and less than desirable results.

What is the consensus on using free gingival graft (FGG) or connective tissue graft (CTG) as a membrane over the top of graft sites with slight exposure of the FGG or CTG, if primary closure is not fully obtained?

Are people using B-TCP as a sole grafting material? Can you expect predictable results using B-TCP for 4 and 3 walled defects?

Is the resulting bone formation derived from such a synthetic material, like Fortoss Vital, sufficient enough for implant placement or is a bone block inevitable?

I did a bone graft and the area has now become infected. I want to get some advice on this and similar cases.

I would like to get some opinions on which membrane to use when I graft with mineralized freeze dried bone allograft material.

Anyone have a similar experience in the mandibular second molar area or have insight as to what maybe causing these clinical symptoms?

I would like to incorporate PRP (Plate Rich Plasma) into my grafting protocols. However, I have been advised by the California State Dental Board that drawing blood is out of the scope of practice of a dentist.

Is it in accordance with the standard of care for general dentists to do bone grafting at the time of implant placement or for site development and socket preservation?

After 4 days, the membrane became dislodged, exposing the socket and the graft. Should I remove the current graft material, do a new graft and place a new membrane.

I am interested in comments regarding simultaneous bone grafting with implant placement in cases with dehiscence.

I have a 31 year old male patient who presents with root tips in the #30 + 19 areas and I’m wondering what treatment plan to pursue.

What is the optimal method for preserving bone following extraction where an implant is to be placed?

At 3-weeks post-operative, the membrane exfoliated by itself. The wound site is epithelialized and the implant platform is exposed.

Recently I have started using Puros Block Allograft of corticocancellous bone for block grafts.

I performed lateral GBR – Guided Bone Regeneration – in the mandible to increase the crestal bone width in the #19,20 area about 4 months ago.