Bone Grafting Consent

Bone grafting adds or preserves supporting tissue where bone volume is insufficient. Material may be obtained from the patient, a screened human donor, an animal source, a synthetic source, or a combination. A barrier membrane, biologic modifier, fixation device, or staged implant procedure may be recommended.

Patients are often not told what graft material is actually made of, and for many people the answer matters. The material used in your case will be one or more of the following, and you are entitled to know which before you agree:

• Autograft — your own bone, taken from another site in your mouth or body.
• Allograft — bone from a screened, processed human donor, supplied by a tissue bank.
• Xenograft — mineral bone from an animal source, most commonly bovine (cow), and sometimes porcine (pig) or equine (horse).
• Alloplast — a synthetic material of no human or animal origin, such as a calcium phosphate or bioactive glass.
• Barrier membranes are a separate material and are most often made from bovine or porcine collagen; a synthetic membrane can usually be substituted on request.

If human-donor or animal-derived material conflicts with your religious practice, dietary practice, or personal beliefs, tell the treating dentist before treatment. In most cases an autograft or a synthetic alternative can be planned instead, though the alternative may change the technique, the timeline, the predictability, or the cost, and the dentist will explain any such trade-off for your case.

Human donor tissue in the United States is screened, tested, and processed under federal tissue-bank rules. The risk of transmitting an infection is considered extremely low, but no processing method can make it zero.

• Pain, swelling, bleeding, bruising, infection, wound opening, graft or membrane exposure, graft loss, or inadequate bone formation.
• Altered gum or bone contours, scarring, sensitivity, damage to adjacent anatomy, or need for revision or additional grafting.
• Disease transmission from screened donor materials is considered remote but cannot be stated to be zero; animal- or synthetic-source materials may cause inflammatory or immune reactions.
• If the patient’s own bone is harvested, the donor site has separate risks including pain, bleeding, infection, altered sensation, and contour changes.
• Use of biologic products has product-specific indications, contraindications, and risks that must be discussed when applicable.

• No grafting, which may limit implant placement or affect ridge contours.
• A different graft material or technique, a narrower or shorter implant, a removable prosthesis, a bridge, or no tooth replacement.
• Referral for another opinion or specialist treatment.