Graft Techniques to Augment the Implant Site–Methods to Minimize Patient Morbidity

There is a continuing trend in implant treatment to develop techniques and materials that minimize treatment length and patient discomfort. Bone augmentation techniques have been developed that provide predictable results with minimal morbidity. The mandibular ramus and tibia have been found to offer excellent bone volume with minimal associated complications compared to other donor sites. Particulate bone can be harvested from the mandible with bone scraping devices or block bone grafts can be procured. The tibia offers good quantities of particulate cancellous bone. Techniques that utilize titanium mesh and barrier membranes allow the use of particulate bone grafts to reconstruct larger defects in a simplified manner. Allogeneic bone blocks eliminate the morbidity of graft harvest but have limitations in their use. Particulate minerialized bone allograft may be used for socket grafting and site preservation in preparation for implant placement. Methods to enhance the outcome of bone grafting procedures will be discussed including site development, provisional prostheses, and staged implant placement. The incidence of complications and methods to avoid complications will be addressed.