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Bone Grafting in Oral Implantology: Techniques and Clinical Applications

Dental implants are now considered state of the art in tooth replacement. Countless clinical trials have demonstrated that dental implants provide long-term function and at the same time conserve adjacent teeth by eliminating the need for utilizing them as abutments for conventional fixed prostheses. As clinicians continue to expand and challenge the boundaries of dental implant applications, the need to understand current innovative techniques for bone grafting becomes essential for clinicians involved in dental implant rehabilitation.

The intended purpose of this book is to provide a guideline for postgraduate students in oral and maxillofacial surgery and clinicians involved in oral bone reconstruction prior to dental implant placement. This book uses a photographic rather than a discussion approach to present various bone grafting techniques. As such, the book fulfills the objectives of a clinical color atlas of bone grafting techniques. The author has utilized high-quality photography as well as professional illustrations to explain the techniques and procedures.

There are eleven chapters, commencing with chapters on the biology of bone grafting and general principles of bone grafting. The book starts logically with the first heading as "Why bone grafts?" This provides a brief description to the need for and types of bone grafts. Chapter 2 covers the basic armamentarium used in bone grafting. This is followed by nine chapters according to the location of the harvesting bone sites; these describe techniques of harvesting bone from several locations of the mandible (symphysis, ramus, body, coronoid process), maxilla (tuberosity, sinus wall), the zygomatic, calvarium, iliac crest, and the tibia. Each of these chapters contains basic relevant information about the clinical application, harvesting techniques, armamentarium needed, and potential complications that can be experienced.

Attention is also given to soft tissue management in Chapter 3, where the author emphasizes relieving incisions and partial thickness flaps in order to achieve primary closure over the grafted site. Although the majority of the cases presented represent autogenous bone grafting techniques, several cases also illustrate the use of alloplastic materials as well utilization of platelet rich plasma (PRP).

This book would have benefited from more information on treatment planning and a discussion on the selection of host site as well as some classification and details of various alloplastic bone substitutes used and those currently available. In my opinion, some of the techniques, such as harvesting bone from the cranial vault, the iliac crest, and tibia, appear oversimplified. There is a definite need for more discussion on these sites as these should not be attempted by someone not qualified as a medically trained maxillofacial surgeon.

As a clinical guide, this book has a reasonable bibliography with most chapters, covering clinical as well as research publications. Although some may feel that not enough references have been cited with other chapters, this is probably due to lack of current research in bone grafting for certain procedures described in this book. It would, however, have been useful if more cases were shown to completion with three- to four-year follow-up data and clinical outcomes.

Overall, this is a high-quality book that can be recommended for postgraduate students in oral and maxillofacial surgery as well as periodontists or clinicians involved in bone-grafting procedures for dental implant placement.

Footnotes

Dr. Siddiqui is Associate Professor and Section Head of Dentistry, Aga Khan University Hospital, Karachi, Pakistan and Adjunct Assistant Professor, University of Pittsburgh, School of Dental Medicine. Direct correspondence to him at Aga Khan University Hospital, Section of Dentistry, Department of Surgery, Stadium Road, Karachi, Pakistan; 9221-493-0051, ext. 4689; azfar.siddiqui{at}aku.edu or aas7{at}pitt.edu

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