Many factors go into choosing the best bone graft material for your patients. Most clinicians are trained that autografts are the gold standard and allografts are an acceptable alternative. That may have been true 5-10 years ago, but science has evolved, and studies now prove that beta tricalcium phosphate granules are equal to or superior than the performance of both allografts and autografts.
Below is a list of studies that support these findings:
Does Graft Particle Type and Size Affect Ridge Dimensional Changes After Alveolar Ridge Split Procedure?
J Oral Maxillofac Surg. 2018 Apr;76(4):761-769. doi: 10.1016/j.joms.2017.11.002. Epub 2017 Dec 2.
Conclusion: This ridge split study found that beta tricalcium phosphate granules produced statistically superior results over allograft granules for all particle sizes. In addition, larger particles (1-2mm) performed superior to smaller particles (.5-1 mm).
A prospective multicenter randomized clinical trial of autogenous bone versus beta-tricalcium phosphate graft alone for bilateral sinus elevation: histologic and histomorphometrically evaluation.
Int J Oral Maxillofac Implants. 2005 May-Jun;20(3):371-81.
Conclusion: At 6 months there was no difference in the amount or quality of bone between the two groups.
Long-term changes in graft height after maxillary sinus floor elevation with differed grafting materials: radiographic evaluation with a minimum follow-up of 4.5 years.
Clin Oral Implants Res. 2009 Jul;20(7):691-700. doi: 10.1111/j.1600-0501.2008.01697. x.
Conclusion: After 4.5 years there was no difference in the amount of bone regeneration between the autograft and beta tricalcium phosphate groups.
Maxillary sinus floor augmentation using a beta-tricalcium phosphate alone compared to autogenous bone grafts.
Int J Oral Maxillofac Implants. 2005 May-Jun;20(3):432-40.
Conclusion: Both autograft and beta tricalcium phosphate grafts produced adequate bone for implant placement and both materials had a 100% implant success rate after one year.
Osteoinductive ceramics as a synthetic alternative to autologous bone grafting.
Proc Natl Acad Sci U S A. 2010 Aug 3;107(31):13614-9. doi: 10.1073/pnas.1003600107. Epub 2010 Jul 19.
Conclusion: This was a critical size defect in sheep that found a third-generation beta Tricalcium phosphate yielding significantly more bone production than autograft and BMP2.
Early implant survival in the posterior maxilla with or without beta-tricalcium phosphate sinus floor graft.
J Oral Maxillofac Surg. 2010 Jul;68(7):1642-5. doi: 10.1016/j.joms.2009.08.028. Epub 2010 Apr 10.
Conclusion: Sinuses were grafted with beta tricalcium phosphate with simultaneously placed implants. This group was compared to maxillary posterior implants that were placed without the need to do sinus augmentation. Both groups experienced 99% success rate after approximately 30 months.
Chronic infection and infected non-union of the long bones in pediatric patients: preliminary results of bone versus beta-tricalcium phosphate grafting after induced membrane formation.
Int Orthop. 2018 Feb;42(2):385-393. doi: 10.1007/s00264-017-3693-x. Epub 2017 Nov 28.
Conclusion: In the treatment of chronic osteomyelitis, beta tricalcium phosphate performed better than allograft.
Use of autogenous bone and beta-tricalcium phosphate in maxillary sinus lifting: histomorphometrically study and immunohistochemical assessment of RUNX2 and VEGF.
Int J Oral Maxillofac Surg. 2017 Apr;46(4):503-510. doi: 10.1016/j.ijom.2017.01.002. Epub 2017 Feb 6.
Modern beta tricalcium phosphate bone grafts perform as well or better than allografts or autografts. The negatives of autograft morbidity and cadaver harvesting makes high performing βTCP a superior choice.
Conclusion: Beta tricalcium phosphate alone performed better than βTCP when combined with autograft and better than autograft alone.
