Bone Grafts

Bone Grafts

Bone grafting procedures are usually necessary if there is not enough bone available to place dental implants or if any vital anatomy is in the way.

Today, bone grafting procedures have become almost an integral part of implant reconstruction. In many instances, a potential implant site in the upper or lower jaw does not offer enough bone volume or quantity to accommodate a Root form Dental Implant of proper size or in the proper place. This is usually a result of bone resorption that has taken place since one or more teeth (if not all) were lost. Bone Grafting procedures usually try to re-establish bone dimension, which was lost due to resorption.

Many years ago the lack of bone posed a considerable problem and sometimes implant placement was impossible because of that. Today, however, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width (and for Root form Implants we always try to go for as long and wide as possible), it also gives us a chance to restore the esthetic appearance and functionality better.

Our clinic use bone grafting and tissue regeneration products from Osteohealth Company .The products of this company have been used by dental professionals throughout the world. The company's overriding goal is to develop and distribute, with professionalism and integrity, products of the highest quality that have been scientifically and clinically proven to enhance patient care.

Bio-Oss® Natural Bone Grafting Material

Bio-Oss® is a natural, osteoconductive bone substitute that promotes bone growth in periodontal and maxillofacial osseous defects. It consists of the mineral portion of bovine bone. Bio-Oss® provides the body with a matrix for bone cell migration and is integrated into the natural physiologic remodeling process. 
Bio-Oss® natural bone mineral offers predictable results which have been proven through years of clinical experience and extensively documented in published scientific literature.

Bio-Oss®: Morphology like human bone

Bio-Oss® was developed as an ideal bone substitute that would replicate the structure of autogenous bone. Each step in the development of Bio-Oss® was conducted with this goal in mind, resulting in a matrix that is very similar in physical and chemical composition to human bone. 
The trabecular architecture and fine crystalline structure of the natural bone in Bio-Oss® are preserved through a patented manufacturing process, resulting in an exceptional osteoconductive matrix.

High similarity of Bio-Oss® to human bone

Bio-Oss® Cancellous Structure

Autogenous Bone Structure

Bio-Oss® - small and compact nanocrystals 
similar to human bone. (TEM 100,000x)



Human bone - small and compact 
natural apatite crystals (TEM 100,000x)



Process of natural bone regeneration with Bio-Oss®


1.     Clot stabilization facilitated by Bio-Oss® interconnecting macro and micropores.

2.     Revascularization, migration of osteoblasts (purple) and in-growth of woven bone (yellow) is enhanced by Bio-Oss® scaffolding.

3.     Lamellar bone and Bio-Oss® are successfully integrated after approximately six months. Bio-Oss® is included in the natural physiologic remodeling process (osteoclasts - Blue).

Advantages of Bio-Oss®

  • Superior handling characteristics made possible by the large hydrophilic inner surface area similar to human bone.
  • Promotes revascularization and clot stabilization, due to its interconnecting macro and micropores.
  • Facilitates bone formation by providing an exceptional osteoconductive scaffolding which results from the retention of the natural porous architecture and trabeculation of human cancellous bone.
  • Effective space maintenance, and when integrated, provides mechanical strength and stiffness due to retention of the natural mineral content.
  • Optimal integration with patients own bone aided by a chemical composition analogous to human bone with fewer hydroxyl and more carbonate groups than most synthetic materials.
  • Bio-Oss® is integrated during the natural remodelling process of the human bone and slowly resorbed due to small crystallite size which is comparable to human bone.
  • Effective bone regeneration that has been clinically and scientifically proven for more than 15 years.

Bio-Oss® prevents newly formed bone from rapid resorption and leads to a long-term preservation of the bone volume.

Bio-Gide® Resorbable Bilayer Membrane

Bio-Gide® consists of highly purified collagen types I and III (porcine origin). The membrane is highly biocompatible and supports wound healing. The three-dimensional, natural fiber structure promotes cell adhesion, serves as a matrix for soft tissue support and provides a barrier to the ingrowth of overlying soft tissue into underlying bony defects.

Experience shows there is low risk of postoperative membrane exposure. Should wound dehiscence occur, soft tissue healing and closure of the dehiscence defect usually follows.

The barrier function of Bio-Gide® lasts for several months prohibiting soft tissue ingrowth into the bony defect facilitating undisturbed bone regeneration. Resorption takes place enzymatically and without irritation.

The native collagen fibers of Bio-Gide® are strongly hydrophilic. As a result, once moistened, the membrane adapts very well to the surgical site.

Bio-Gide® bilayer design, cross section (SEM 100x)

The Bio-Gide® membrane consists of collagen types I and III which have been prepared to result in a bilayer membrane. The dense superior membrane layer, which faces the soft tissue, is cell occlusive and prevents invasion of soft connective tissue cells into the membrane protected space. The porous inferior layer, which faces the bony defect, consists of loosely arranged collagen fibers which act to stabilize the clot and enable bone cells to become integrated into the membrane. 

The dense cell-occlusive layer is a barrier to soft tissue ingrowth and serves as a soft tissue scaffold (blue arrows). Granulation cells adhere to the natural collagen surface.

The porous side of the membrane is an open-pore, three-dimensional collagen matrix, which promotes cell integration (white arrows).

High similarity of Bio-Gide® to human collagen membrane

Bio-Gide® - natural collagen structure (SEM 2000x)

Human Schneiderian membrane dissolved on the bony side. 
SEM view 2000x (Prof. K. Brenner, Anatomy Institute, LMU Munich)

Advantages of Bio-Gide®




Tear-proof fibrous tissue structure

May be trimmed to desired size/shape and subsequently fixed in place either by adherence or fixation with pins/sutures

Easy to handle and perfect adaptation to the defect

Matrix with a bilayer structure

The smooth cell-occlusive layer forms a natural barrier against soft connective tissue cells
The porous layer favors bone tissue integration

Long term undisturbed bone regeneration

High-tech purified collagen-fibers

Accelerate bone cell adherence and blood clot stabilization
Resorption without irritation of the tissue by acid formation

Favorable soft tissue
healing Single step surgery