Bone graft materials are usually grouped by where they come from: the patient, another person, an animal, a laboratory, or a tooth. This article sets out how the published literature defines each group, and what systematic reviews found when they compared groups in ridge preservation. It is a reference for clinicians. It does not recommend a product.

Three properties used to compare grafts

• Osteogenic materials contain living cells that can differentiate into bone.
• Osteoinduction is the process by which new bone formation is induced from osteocompetent cells.
• Osteoconduction is bony ingrowth from local osseous tissue onto the graft surface.

A material can have one, two or all three. The categories below differ mainly in which of these they are described as having.

Autografts: the patient’s own bone

Autologous bone is taken from the patient, for example from the iliac crest or the calvaria for large defects. The review describes it as the reference material for bone grafting because it is biocompatible, osteogenic, osteoinductive and osteoconductive.¹ Its drawbacks are the need for surgery at a donor site, limited availability and an uncertain prognosis.¹

Allografts: human bone from another person

Allografts are human bone from a donor other than the patient, selected and processed before use. Ferraz describes them as osteoinductive and osteoconductive but not osteogenic. The same review notes continuing debate about immune response and disease transmission, and that processing reduces some biological and mechanical characteristics.¹

Xenografts: bone from another species

Xenografts are bone from animals. According to the review, their osteoconductivity comes from the inorganic structure, mainly hydroxyapatite, left after organic components are removed. Their osteoinductive capacity is described as questionable when no organic component remains.¹

Alloplasts: synthetic materials

Synthetic materials include ceramics, bioactive glasses, polymers and synthetic hydroxyapatite. The review lists biocompatibility, osteoconduction and easy handling among their advantages. It also notes that calcium phosphates may lack osteoinductivity, which restricts their use in larger defects.¹

Tooth-derived grafts

Does the category change ridge preservation outcomes?

Two systematic reviews of alveolar ridge preservation (ARP) compared material categories.

Read together, these reviews suggest that grafting itself matters more for ridge dimensions than the choice of material category. Long-term outcome data, such as implant failure and aesthetics, remain limited.³

Choosing a material

Ferraz lists the factors that drive selection: material availability, defect size, the size, shape and volume of graft needed, biomechanics, handling, cost, ethical issues, biological characteristics and associated complications.¹ Two practical points follow:

1. Check the indication list. Every graft is cleared or notified for specific indications. Use it only within the indications in its Instructions for Use.
2. Read the precautions and the healing time. These vary between products. For example, the AmGraft IFU states that the product is not intended to bear mechanical loads and recommends a minimum of 6 months’ healing at the augmented site.⁵

Clinicians who want AmGraft’s full IFU-based reference (indications, contraindications, precautions and handling) can find it in the professional area.