Autogenous bone graft after tenting?

Last Updated: Oct 24, 2019

I posted a tenting case question a couple months ago (See: Tenting screws at grafting site: advice?) and it did fine so this is a follow up. I gained 3mm height and I want to gain another 5mm. The patient is now 5 months into healing and I now want to place a block graft. I have used 5mm block bovine grafts in the past but I am on board with an autogenous block graft. I am considering the tuberosity area of cortical and D4 as a block but I would rather have D2. Would a one-piece cortical bone and Ti-PTFE (see: Titanium Reinforced PTFE Membranes) provide what I need?

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Greg Kammeyer, DDS, MS, D

10/31/2019

I encourage you to consider the allogenic block with rhPDGF or BMP rather than an autogenous block or BMP with TiMesh (my preferred method to grow significant bone. D2 blocks are very avascular and if you look at lectures photos you'll see alot of white blocks at uncovery, That in my opinion means they are avascular and after 20+ years of using them, I am cautious to assume they will remain stable long term. Too many of them get necrotic long term. Is a short implant an option?

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