How do I determine the best grafting material for my application?

Considerations for choosing the best grafting material for my surgical case.

This is a very long and involved answer to a simple question; and it is not that simple to answer.

It can depend on the following:

  • Patient’s clinical conditions; age, medical condition.
  • Does the patient have a preference when choosing a bone graft: allograft vs autograft, xenograft over allograft or, due to an aversion to human or biologic bone. Or would their preference be an alloplast over synthetic bone?
  • Procedure being performed; socket preservation, lateral ridge augmentation, or sinus lift.
  • Are there any time constraints? Does the patient want the implant done sooner rather than later?
  • What type of host bone are we dealing with at the surgical site? Type D1, Type D2, D3 or D4 ( they all heal at different rates).
  • If the patient has poor tissue, poor blood flow due to medical complications, is over the age of 40, the procedure is a socket preservation, but you are presented with three walls versus the usual four. 
  • If the patient wants the graft done in 5 months versus the usual 6 to 9 months, you may choose a material like the PentOS OI™ Putty which is made from 100% human bone without any additional diluent or carriers to diminish its osteoinductive properties. Due to its speedy turnover and putty-like consistency which holds all the graft material at the surgical site, it may be the right choice. 
  • If we are talking about a 25 year old with good tissue, no medical compromising conditions and a four wall socket defect, using a regular particulate such as Raptos®, and re-entering in 5 to 7 months might be the right choice.


There is a lot to consider, but it comes down to patient considerations and requirements, time and location of surgical procedure. Each dental surgeon will have to make their own decisions when it comes to protocols.