Bone Grafting: Techniques and Outcomes

This assignment delves into the world of bone grafting, examining different surgical approaches and their associated outcomes. It covers a range of topics, from autologous bone grafts to free vascularized fibula grafts, highlighting the diverse applications and benefits of these procedures. The document also analyzes complications and patient experiences, offering a comprehensive overview of bone grafting in various medical contexts.

Bone grafting: To graft or not
to graft?

TABLE OF CONTENTS
Topic: Bone grafting: To graft or not to graft?..........................................................................1
INTRODUCTION...........................................................................................................................1
Overview of chosen topic:........................................................................................................1
DISCUSSION................................................................................................................................2
Overview on the bone grafting procedure.............................................................................2
Advantages of the bone grafting procedure for patient centred care...............................2
Disadvantages of the bone grafting procedure for patient centred care..........................4
CONCLUSION...............................................................................................................................5
REFERENCES..............................................................................................................................7

Topic: Bone grafting: To graft or not to graft?
INTRODUCTION
Bone Grafting is defined as the surgical procedure to provide treatment for the damaged
bones through transplantation of bone. This is mostly done on any part of the body and is
performed either on legs or ribs or hip bones. Herein, the surgeons are specialised in the
insertion of a bone in a particular place where the bone is not fully healed or needs repair due to
large bone crumbling. Next the healing initiates where the new bone cells get sealed to the old
bones and leads to growth with proper bone healing (Tormenti and McLaughlin, 2019). There
are several environmental conditions that might need a bone graft and involves compound
fracture, spinal fusion surgery, diseases like cancer, osteonecrosis etc., knee replacement and
any dental implant surgery. However, there are risks associated with it such as infection or
bleeding due to anaesthesia but the success rates are higher and have brought radical effects
for people with some bone dysfunctionality.
Furthermore, there are types of bone grafts using either natural or artificial substitutes
and must have specific features to be suited for this procedure. Bones are porous and have
several minute holes where these replacements get added/grafted for nutrients exchange via
blood vessels and promote new formation and growth of bones. Mostly natural substitutes are
used and are considered by using autografts and allografts (Pommer and et.al., 2012). For
instance, hydroxyapatite is a rich calcium phosphate based mineral and are found in bones and
teeth. This is used for hand surgery, cranioplasty and dental procedures. Additionally, the
implementation of screws, wires, cables, plates etc. must be held to place the grafted bone. It
also requires proper recovery planning to bring improvisations in maintaining the health of the
affected individual. Thus, bone grafting are beneficial as fillers and assist in bone formation to
overcome the damaged or repaired bones in organized manner.
Overview of chosen topic:
This assignment is based on understanding the decision-making process while taking
the grafting procedure or not by the individuals. It also includes about the assessment regarding
the queries and associated dilemmas in terms of risks, recovery time, usage of resources and
more while making decisions. In addition to this, this would provide an overview whether to
adopt this medical procedure or not and emphasis on the relevant conditions that helps the
individuals in opting for this procedure or not using it.
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DISCUSSION
Overview on the bone grafting procedure
The major issue of this assignment is to decide to graft or not procedure is implemented
in context to an individual case. Before making any conclusions, it is important to understand
when this medical procedure is adopted and when it is not recommended under the professional
framework. Grafting has been considered as one of the effective medical inventions that have
saved lives to people who met with any uncertain accident and has encountered any damage or
fracture with some deformation (Solakoglu and et. al., 2019). This procedure has helped the
affected individuals by focusing on restoring and maintaining the entire location where grafting
has been done. In earlier times, the people with fracture or accident injury were mistreated and
never given respect and dignity. The patients were humiliated and were treated as outcasts
from the rest of the society. However, with technological advancements and globalization, it has
become evident that many inventions came into the medical sector.
Bone Grafting procedure is considered as a medical method where the affected patients
get repaired its damaged or fractured bone at any part of the body. It is a known fact about
bones which has the ability to regenerate and are of several types. Primarily, there is a
requirement that a small space or gap is necessary to fill it with substitute and give a support
through using mechanical materials like crews, plates etc. (Siaili, Chatzopoulou and Gillam,
2018).These maybe of different types but the major purpose is to replace the repaired bones
with new bones using patient's own body or using substitutes or taking help of bone bank. Thus,
it is clear that this method is used only when the principles are in match with the bone structure
of the patient and it is feasible to conduct the grafting operation using any of the prescribed
type.
Advantages of the bone grafting procedure for patient centred care
When the scenario or situation arises to take this route of grafting, it must be considered
to implement it because it is a viable option and shows optimal results. Moreover, it helps in
making the patient feel normal again by using any of the methods like autologous, synthetic etc.
Additionally, it assists in restoring and maintaining the structural features of the affected patient
and let them recuperate from any marked areas to live life like a normal person. The affected
areas or the jaw or any other bones take the support of the mechanical materials and support
them for complete recovery (Putters, Wortmann and Raghoebar, 2018).
There are minimally invasive procedures which takes place on the body parts like teeth,
fibula or others. However, it is also useful in performing operations on more complicated
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procedures. For instance, dentist or periodontist uses this technique in fixing the smile by the
help of dental implants.
In regard to this, when people are suffering from any missing teeth or need to fix the
jawline or the structural changes, they would contact the dentist and would enquire about bone
grafting by using the dental implants. It also ensures that such dental implant needs to be
functional and must also be undetectable to maintain the safety of patient and prevent them
from any mis-happening after conducting the implants (Provaggi, Capelli and Kalaskar, 2018).
Nevertheless, it also emphasis on using a healthy jaw bone for better survival rate and this
would help in reaching the success rate. This type of bone grafting procedure would prove
beneficial in bringing back smiles of the affected patients. Moreover, it is becoming normal and
people are reliability opting for this procedure since the strength and stability of the replaced
bone is equally supportive and can be applicable to people of all age groups.
In regard to the above, it has also been seen that patients are not complete aware and
educated about the advantages and associated risk of this bone grafting procedure. This was
not adopted by people in the first place but after consultation and multiple sessions taking, the
patient are made to realise the effects of this procedure (Matson and Richard, 2019). In the
case of bone grafting using dental implants, this methodology has been used to replace the
missing teeth or restructuring the jawbone to give patients a perfect smile. Mostly influential
people and elite class families adopt this technique since they know that it is effective in terms
of giving an individual a better look. Therefore, it is understandable that when an individual
needs corrective action plan to look presentable and sometimes to overcome their insecurities
after meeting with an accident or unforeseen incident.
Consequently, the patients mostly encounter situations in any form and adopt this bone
grafting procedure in accordance to the applicability. Along with this, the grafting procedure is
feasible and viable and has longer results in terms of placement of grafted bone and healing
effectively without the presence of unregulated barriers (Landau, Badash and Patel, 2018). It
has also been found out that patients are given sedations in order to not feel anything in the
entire surgical procedure and maintain the environment organized. Such atmosphere helps the
patients in gaining a wider understanding about the side effects which are mostly negligible and
along with, it leads to make the patients feel secured and safe. Thus, the grafting procedure is
promoted to the people who need it and has been given a wide range of options such as sinus
life procedure, socket bone preservation etc. (Hong and et.al., 2018). The patients might be able
to use this procedure for personal fulfilment of given requirements.
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Disadvantages of the bone grafting procedure for patient centred care
On the other hand, this discussion is now moved towards the discouragement of using
or adopting this surgical procedure for minute corrective plans. It has been demonstrated that
decision making can be made under the professional guidance about the restoration and
restructure method but it is also a known fact that there might be some unaware type of risks
associated with it (Lu, 2018). In context to this, the professionals sometimes play safe and do
not give entire instructions in order to gain patients and this shows the unethical standards and
work ethics. This leads towards the darker side of the medical practices that has been adopted
recently by the practitioners which is unethical and highly unprofessional. The procedural tools
and techniques also needs proper training to be used by the professionals when using them to
fulfil the requirements. However, this is possible in achieving but sometimes it leads to
malpractices and inconvenient.
Moreover, the professionals also lack the technical expertise while performing the
surgeries and this prove fatal for the lives of the affected patients. This procedure is considered
among the few expensive techniques and requires substantial amount since the fillers and other
materials used must be of good quality (Jung, Takeuchi and Nag,2019). It is also necessary to
make the patients give consultation but in most of the cases, the consultation is on tertiary
levels. Thus, this sometimes misguides them and act as barriers in terms of communication and
implementation aspects. For instance, when the individual undergoes bone grafting using dental
implants and try to fill up the tooth through using a metal post that is mostly inserted in the jaw
bone as an artificial substitute. This sometimes takes proper time to get settled in and due to
any hurry or disorientation shown by the patient might prove disadvantageous for the recovery
stage (Aslanturk and et.al., 2018). It has been studied that in less than 1 % of cases, the
patients are recoverable and do not face any crucial reactions or risks like reactions to
medicines or anaesthesia or any bleeding.
It has also been found out that the rehabilitation phase is predictable and easier stage of
the entire bone grafting technique. However, due to the uncertainties attached with the
therapeutic sessions and diagnostic results might affect the patient's chances of complete
recovery (Berridge and et.al., 2018). The preferences of the families and the values inculcated
in the patients' personalities also proved as another factor that might lead to the inconsistencies
in the evidence based approaches of this procedure. The cost considerations are sometimes
reached the secondary spot, however the time efficiency is crucial in this procedure. It is long
standing process if any risks such as bleeding, inflammation, reabsorption of graft and more
arises or leads to ineffective outcomes. Thus, it is important to understand that this surgical
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procedure comes under permissible limits in order to conduct it to ease the patients with their
pain levels or any deformed structure (Correia and et.al., 2018). However, the risks are
unregulated and needs to be conversed beforehand to the candidates for better treatment plan
and the maintenance of success rates.
To sum up, it is clear that the bone grafting process is beneficial in all forms and must be
recommended to the people with proper set of guidelines to make the decision making easier
and convenient for both parties. There must be a loop of structured channels to give the
consultation and suggestions for better accessibility in dealing with patients' queries and helping
the practitioners to forecast and benchmark as well. Forecasting is essential to maintain the
quality management and assist the patients' in attaining the desired results. In combination with
it, benchmarking keeps a check on the credibility, transparency and reliability of the patients'
recovery plan (McCann Berger and O'Malley Jr, 2018). These two parameters must also be
kept in mind to avoid the mistakes and present a robust recovery plan to use for the betterment
of the patients during their rehabilitation plan. Henceforth, the bone grafting method must be
promoted to be adopted by the professionals with its benefits like less evasive, few chances of
risks.
CONCLUSION
It has been demonstrated that bone grafting procedure is feasible and cost effective
method for the people who are in need of it. This surgical procedure is slowly gaining popularity
and has been considered by many people for the damages or repair work in any part of the
body including teeth, jawbone, fibula or femur part. Along with this, the topic of this assignment
is in favour of it with the provided evidence of practices in all around the world. There are
misconceptions regarding this method and people must be given training or awareness
generation programs to make it reachable among the public. It has also been discussed that this
procedure has both pros and cons, however it is more advantageous with minimal risks and that
could also be eliminated with passage of time.
This grafting procedure came as blessing for the affected patients who either had some
defects or met with accident or encountered with any war and in terms of giving strength to face
the world. Thus, the evidence of practice has successfully highlighted the need of this procedure
to fulfil the requirements of people who are in need of such methods' and gave a complete
overview in completing the recovery stage effectively. Moreover, it focused on reconstructing
the deficiencies or regeneration procedures despite the undesirability attached with the
prosthetics world and the implantation techniques.
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REFERENCES
Books and Journals
Aslanturk, O. and et. al., 2018. Clinical results of anterior cruciate ligament reconstruction with
bone-patellar tendon-bone autograft: A prospective study. Journal of Turgut Ozal Medical
Center. 25(2).
Berridge, J.P. and et. al., 2018. Focus on Epithelialized Palatal Grafts. Part 1: Multiple Adjacent
Recession Defects in the Mandibular Anterior. Clinical Advances in Periodontics, 8(4),
pp.160-166.
Correia, F. and et. al., 2018. Two-stage sinus lift with two different graft: histomorphometric and
radiological outcomes-split mouth RCT. journal of clinical periodontology.
Hong, C. and et. al., 2018. Local vs. systemic administration of bisphosphonates in rat cleft
bone graft: A comparative study. PloS one. 13(1). p.e0190901.
Jung, W.H., Takeuchi, R. and Nag, R., 2019. Faster union rate and better clinical outcomes
using autologous bone graft after medial opening wedge high tibial osteotomy. Knee
Surgery, Sports Traumatology, Arthroscopy. pp.1-8.
Landau, M.J., Badash, I and Patel, K.M., 2018. Free vascularized fibula grafting in the operative
treatment of malignant bone tumors of the upper extremity: A systematic review of
outcomes and complications. Journal of surgical oncology. 117(7). pp.1432-1439.
Lu, X., 2018. Characterization of Biomimetically Enhanced Anorganic Graft Material for Bone
Regenerative Applications (Doctoral dissertation).
Matson, A.P. and Richard, M.J., 2019. Determination of the Optimal Location for Bone Graft
Harvest in the Distal Radius. HAND, p.1558944719832041.
McCann, A.C., Berger, C. and O'Malley Jr, B.W., 2018. Novel approach using transoral robotic
surgery for resection of cervical spine chordoma. The Laryngoscope.
Provaggi, E., Capelli, C. and Kalaskar, D.M., 2018. A UK-based pilot study of current surgical
practice and implant preferences in lumbar fusion surgery. Medicine. 97(26).
Putters, T.F., Wortmann, DE and Raghoebar, G.M., 2018. Morbidity of anterior iliac crest and
calvarial bone donor graft sites: a 1-year randomized controlled trial. International journal
of oral and maxillofacial surgery. 47(11). pp.1474-1480.
Siaili, M., Chatzopoulou, D. and Gillam, D.G., 2018. An overview of periodontal regenerative
procedures for the general dental practitioner. The Saudi dental journal. 30(1). pp.26-37.
Solakoglu, Ö. and et. al., 2019. Characterization of circulating DNA in plasma of patients after
allogeneic bone grafting. Clinical oral investigations. pp.1-11.
Tormenti, M.J. and McLaughlin, M.R., 2019. An Overview of Various Surgical Approaches. In
Degenerative Cervical Myelopathy and Radiculopathy (pp. 185-194). Springer, Cham.
Online
Pommer,B. and et.al., 2012. To Graft or Not to Graft? Evidence-Based Guide
to Decision Making in Oral Bone Graft Surgery. [Pdf]. Accesssed through:
<http://cdn.intechopen.com/pdfs/33465.pdf>.
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