Simple Ridge Augmentation:The Advantages and Disadvantages of Regenerative Medicine vs Cadaver Bone Grafts
This is the 4-month case from the beginning of this article shown for comparison. Since all the pre-graft resorption occurred on the buccal, the membrane was applied directly over the lingual cortical bone. After placing the membrane, graft material was placed on the buccal surface only. This located the graft material within the borders of the original mandible. As a result, the graft material was completely resorbed and converted into vital bone.
One of the limitations of regenerative medicine is that we are unable to regenerate a damaged tissue outside of the confines of the original dimensions of the bone, determined by the genetic code that grew the bone originally. Using regenerative medicine, the best we can do is to regenerate what was lost. The bone on the buccal and lingual of the mandible that contains residual βTCP particles is not normal bone and cannot be relied upon to properly integrate and support dental implants. Cadaver bone grafts do not have this limitation. Cadaver bone grafts are not guided by the genetic control of your patient’s cells and wherever you can obtain mineralization, the graft material will remain. Because cadaver bone grafts never remodel once the mineralization process has occurred, the shape of the bone is fixed indefinitely. This allows creation of mineralized tissue outside the preexisting confines of the patient’s original bone.
An advantage of regenerative medicine, however, is that once the bone has formed, it is normal bone and the newly regenerated bone will integrate to the implant in the area of regeneration. The disadvantage of cadaver bone is that it has never been shown to integrate to the implant surface and the implant is supported only by the basal bone that existed prior to grafting.
Another disadvantage of using regenerative medicine materials and methods is that it requires more knowledge and skill to regenerate normal healthy vital tissue when compared to cadaver bone grafts that produce sclerotic bone, which equates to scar tissue.
Every material has its pros and cons and knowing what you want to achieve with your surgical procedure will determine what material is best suited for the desired result.
Follow the link below to see the step-by-step breakdown of the case presented: