3. What is graft ? A viable tissue that after removal from a donor site is implanted with in a recipient tissue is then restored repaired & regenerated. What is grafting ? Grafting is a procedure used to replace / restore missing bone or gum tissue.
4. What are bone grafts? Bone grafts are the materials used for replacement or augmentation of the bone.
10. Osteogenesis : Osteoblasts in the transplanted bone having adequate blood supply & cellular viablity. Forms new centers of ossification within the graft
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12. Autografts: A tissue transferred from one position to another within the same individual . Allografts / Homografts: Obtained from genetically dissimilar individual of same species . Xenografts / Hetrografts: Tissue transferred from one species to another species. Alloplasts: A synthetic graft or inert foreign body implanted into tissue.
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18. Bone Swaging: Technique requires existance of an edentulous area adjacent to the defect from which bone is pushed into contact with the root surface without fracturing the bone at its base.
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24. Frozen iliac crest marrow Need for cross – matching to decrease the likelihood of graft rejection as well as disease transmission eliminate the use of frozen iliac crest marrow.
25. Xenografts: Anorganic bovine bone (ABB) : Bovine bone that has been chemically treated with ehylenediamine to remove its organic components, leaving a trabecular & porous architecture similar to human bone.It is osteoconductive. Boplant: Calf bone treated by detergent extraction, sterlized in propriolactone & freeze dried.
26. Kiel bone : Calf / ox bone denaturated with H2O2 (20%) dried with acetone & sterlized with etylene oxide. Ospurane: Cow bone soaked in KOH , acetone & salt solution. Boiled bone: Cow bone boiled or autoclaved.
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29. Bioceramics: Composed of CaPO4 with Ca & Po4 ratio similar to bone Beta tricalcium phosphate: Porous form of CaPo4 Hydroxyapetite: Porous non resorbable Solid non resorbable or solid resorbable.
30. Polymers: 2 types 1) A non-resorbable , calcium hydroxide coated co- polymer of poly - methyl – methacrylate(PMMA). 2) Poly – hydroxylethyl - methacrylate(PHEMA) / (HTR) Hard tissue replacement.
36. A sulcular incision full thickness flap is reflected. A three wall intrabony defect is visualized at the distal of the first molar. Flap design
37. Defect or root debridement Rotary instrumentation using a multifluted surgical length bur on a high-speed handpiece is needed to gain access to the depth of the lesion and to plane the root surface, which is subsequently treated with citric acid (pH 1).
38. Graft management The choice of graft material should be based on clinical considerations, including treatment objectives and potential patient morbidity. If morbidity with graft procurement is a concern, an allograft of demineralized freeze-dried bone may be used. There are no reports of disease transmission, graft rejection or ankylosis after the use of demineralized freeze-dried bone allograft.
39. Placement of demineralized freeze-dried bone allograft is accomplished with light incremental pressure so that the graft overfills the defect. The root surface has been treated with citric acid (pH 1) and the defect has been decorticated.
40. Flap closure A monofilament suture is used to close the flaps by primary closure.