The impact of nonautogenous bone graft on orthodontic treatment

Objectives: Guided bone regeneration with alloplastic bone graft substitutes has a high impact in surgical dentistry nowadays. In the future, the orthodontist will inevitably be confronted with patients with such a medical history. A review of the literature was performed to investigate present materials used, indications, and concerns and problems in interdisciplinary treatment of patients with nonautogenous bone grafts. Method and Materials: An electronic key word search in the literature database PubMed of the US National Library of Medicine and The Cochrane Library (CENTRAL) of the Cochrane Collaboration was performed. Numerous journals were searched manually, and the reference lists of all identified papers related to the topic were reviewed to warrant completeness. All abstracts of the identified publications were screened in duplicate by two autonomous reviewers. Inclusion criteria were the use of a nonautogenous bone graft followed by orthodontic tooth movement or a tooth eruption through the grafting material. Results: The total number of identified publications was 37. It was possible to divide these into two major topics, orthodontic tooth movement in bone graft and tooth eruption through bone graft. Besides experimental setups, indications were periodontal defects, cystic lesions, and alveolar clefts. Here, different types of bone graft were used. The following tooth movement was partially uneventful and sometimes attended by serious adverse effects. The resulting articles presented a low level of evidence and showed diversity in question, methodology, and type of publication. For this reason, it was not possible to perform a quantifying review. Therefore, the articles are discussed in a descriptive manner with regard to the topic in question. Conclusion: Both orthodontic tooth movement and tooth eruption through grafted bone are not only possible but also might provide promising results. However, more research on this interdisciplinary treatment is necessary to avoid risks and achieve more safety in orthodontic treatment of these patients. Keywords: bone defect, bone graft substitutes, guided bone regeneration, orthodontics, tooth eruption, tooth movement