Bone Grafting Case Study Samples

Bone grafting is a surgical procedure intended to replace missing bone tissue in the human body in the event of a fracture or surgical removal due to cancer or in case it has become infective in some other condition. There are several options for replacement of bone tissue in the body. The methods include auto graft (replacement using bone tissue from another part of the person’s body), allograft (from another person) or the use of synthetic bone (for example Nova bone).In this case I would opt to replace the patient’s jaw bone using an auto graft, that is bone from another site in his body for several reasons.

Rationale for Using Bone Grafting

Bone replacement is a surgical procedure, and, therefore, surgical complications are a possibility. A surgery is considered successful in the event that few or no complications occur. All the three methods are aggressive i.e. they involve opening up of part of the human body in order to do them. Therefore, all run the risk of causing the development of infections, fracture, injury to nerves, hematoma or tumour transplantation (Soehardi 100). An auto graft utilises bone harvested from non-essential bones such as from the iliac crest or mandibular symphysis or the anterior mandibular ramus.

Bone Grafting Processes

Bone graft incorporation into the human body involves three processes: osteoconduction, osteoinduction and osteogenesis. A suitable bone graft ought to be able to conform well to all these processes in order to be ‘accepted’ by the body. Osteoconduction is the provision of a passive porous scaffold to support or direct bone formation. Osteoinduction is the property of the graft to induce differentiation of stem cells into osteogenic cells i.e. new bone cells. Osteogenesis is the ability of the bone to provide stem cells with osteogenic potential that lay done directly new bone (Jing 35). An autogenic bone graft has all the three properties. An allograft possesses osteoconductive properties and some osteoinductive properties, but no osteogenic properties.ie.it cannot form new bone cells. An alloplastic graft (for example Nova bone) only has osteoconductive properties. Thus, only an auto graft possesses the potential to lay down new bone.

Risks of Bone Grafting

All transplant operations face the risk of rejection by the host’s body. Rejection means the body recognises the new organ or tissue as foreign and react to it as foreign and initiates a variety of processes intended to get rid of the body. Allografts and alloplastic grafts both involve the introduction of foreign bodies into the human body and, therefore, face the risk of being rejected by a person’s immune system (Morrison 14). Therefore to reduce the risk or severity of rejection, the patient is usually placed on a regimen of drugs intend to suppress the immunity of the person so as to minimise the risk of rejection. However, this is costly to the patient in various ways. For instance, since the patient’s immunity has been suppressed by the immune-suppressive drugs, he or she is likely to get bacterial and fungal infections that would not affect a normal individual. Since an auto graft is part of the patient’s body, the body cannot reject the bone. Consequently, the patient would neither have to spend additional costs on buying new drugs for immunosuppression or get worried about being infected by other diseases (Jing 35).
Lastly, an auto graft is the superior option of the three because of its convenience. Getting an individual that can donate an organ is one of the hardest things in the practice of medicine. In addition for the foreign organ to be viable, it has to have a near or perfect genetic make-up i.e. perfect match. Even if my patient finds such a perfect match, there is risk that damage might have been happened already due to the missing jaw, that is, it might be too late. Using one’s bone is more convenient as there is no need for any search for a donor and, as a result, it saves time and costs that would have been wasted doing that. Therefore, my decision would be to use an auto graft because of its limited risks for post-surgery complications, lower costs and because it is more convenient.

Works Cited

Jing, Wei, et al. "Reengineering autologous bone grafts with the stem cell activator WNT3A." Biomaterials 47 (2015): 29-40.
Morrison, M. D., and D. J. Sputa. "Reconstruction of the temporomandibular joint after surgical ablation of a multiply recurrent ameloblastoma: a case report." Journal (Canadian Dental Association) 80 (2014): e14-e14.
Soehardi, A., et al. "Stability, complications, implant survival, and patient satisfaction after Le Fort I osteotomy and interposed bone grafts: follow-up of 5–18 years." International journal of oral and maxillofacial surgery 44.1 (2015): 97-103.