Periodontics · patient case question
Which grafting material is preferred when the objective is to stimulate new bone formation rather than simply to fill space?
Patient case: Advanced Periodontitis
demo: 48-year-old male
chief: “My teeth are moving and I have gaps that were never there.”
history: Type 2 diabetes, HbA1c 8.4%. Smokes 15 cigarettes per day.
meds: Metformin
findings: Probing depths 7–10 mm generalized. Interdental clinical attachment loss extending beyond the middle third of the root at more than five teeth. Class II furcations at #3 and #14, tooth mobility degree 2, pathologic migration with flaring of the maxillary incisors, 18 remaining teeth. Radiographic bone loss has advanced 3 mm in the last 4 years.
Show answer and explanation
Correct answer: D. DFDBA, because demineralization exposes bone morphogenetic proteins and makes it osteoinductive
- A. FDBA retains its mineral and is osteoconductive; it provides a sturdy scaffold and structural support, not induction.
- B. Synthetic hydroxyapatite is osteoconductive only — it is an alloplast with no living cells and no inductive proteins.
- C. Autogenous bone is the only material that is genuinely osteogenic, because it carries viable cells; describing it as purely osteoconductive understates it.
- D. Correct. Demineralized freeze-dried bone allograft exposes BMPs in the matrix, giving it osteoinductive potential — it recruits and differentiates host cells into bone-forming cells.