The success of any bone graft depends on numerous factors. Essential is graft stability to reduce micromotion and scar tissue creation, a good blood supply to nourish and revascularize the site and the availability of a biocompatible scaffold to host the clot and immature bone.
In a previous article titled degranulation and bone healing, we described the importance of removing all unwanted soft tissue that will compete with the new bone for space – especially so in an extraction socket.
WHAT IS DECORTICATION?
Decortication is a task that follows degranulation and creates the ideal bone site to increase the vascularity of the wound and release growth factors and cells with angiogenic and osteogenic potential.1
Studies report that decortication:
- Facilitates immediate angiogenesis. 1
- Increases the migration of osteoprogenitor cells from the bone marrow into the defect. 2
- Improves new bone regeneration. 3
- Increases the direct contact between a bone graft and the defect wall – especially beneficial when undertaken with a form-stable bone graft material like Powerbone Dental Putty.
Professor Daniel Buser (1996) outlined the importance of bone bed decortication and the role it plays in graft success and recommends ‘perforation of recipient’s bone’ prior to grafting.
Bone decortication can be undertaken with a curette. However, this can be cumbersome and generates more pain and inflammation than is ideal.
BIONNOVATION DECORTICATION DRILL
A new option is to use the Bionnovation decortication drill from Regen Store. This simple, reusable and inexpensive tool is designed to efficiently and safely decorticate the bone surface prior to grafting.
Produced in surgical grade stainless steel (I ASTM F899 440) the Bionnovation Decortication drill is available in 3mm or 4mm lengths both of which are used at 50~300 rpm in the contra-angle handpiece. The incorporated drill stopper removes the risk of over drilling.
Each drill is available from Regen Store at £55 (+VAT for UK Customers). https://tinyurl.com/3tz6rsud
Alternatively, advocates of true bone regeneration using form stable, resorbable, membrane-free synthetic bone grafts can get one FREE when they purchase 5 pre-filled syringes of Powerbone Dental Putty.
More Info here: https://tinyurl.com/yc5zt4mc
- McAllister, B. S., & Haghighat, K. (2007). Bone augmentation techniques. Journal of Periodontology, 78(3), 377-396.
- Nociti Junior FH, Stefani CM, Machado MA, Sallum EA, Toledo S, Sallum AW. Histometric evaluation of bone regeneration around immediate implants partially in contact with bone: A pilot study in dogs. Implant Dent 2000;9:321-328.
- Acar, Ahmet Hüseyin DDS, PhD; Alan, Hilal DDS, PhD; Özgür, Cem DDS, PhD; Vardi, Nigar; Asutay, Fatih DDS, PhD; Güler, Çiğdem DDS, PhD Is More Cortical Bone Decortication Effective on Guided Bone Augmentation?, Journal of Craniofacial Surgery: October 2016 – Volume 27 – Issue 7 – p 1879-1883. doi: 10.1097/SCS.0000000000002932.