BoneGrafting

Bone grafting is a surgical procedure in which bone tissue or a bone substitute is placed at a site of a bone defect or nonunion to promote bone regeneration. Grafts can provide a scaffold for new bone growth (osteoconduction), raise signaling that stimulates bone formation (osteinduction), or supply living bone-forming cells (osteogenesis), depending on the material used.

Grafting materials come from several sources. Autografts use the patient’s own bone, usually from a donor site such as the pelvis, and are valued for their osteogenic potential but require an additional surgical site. Allografts originate from human donors and are processed to reduce immune reaction and disease transmission. Xenografts come from animals and are primarily osteoconductive. Alloplasts are synthetic or inorganic materials, such as calcium phosphate or bioactive glass, designed to support bone growth.

Indications span orthopedic and dental applications. They are used to treat fracture nonunions, fill bone gaps after tumor resection or trauma, enable spinal fusion, and augment the alveolar ridge for dental implants or other craniofacial reconstructions. Procedures vary by site and may involve shaping the graft, securing it with plates or screws, and sometimes using growth factors to enhance healing.

Healing depends on stability, blood supply, graft type, and patient factors such as smoking or diabetes. Radiographic evidence of bone union can take several months. Risks include infection, graft resorption or failure, donor-site morbidity for autografts, nerve injury, and disease transmission in allografts. Alternatives include synthetic substitutes and biological mediators that promote bone formation.