1. Autogenous bone graft
   1. Intra oral sites
      1. Bone Trephine—> External oblique ridge, maxillary tuberosity, symphysis
      2. Osseous Coagulum—> combination of Bone dust + Blood
      3. Bone Bend
      4. Bone swaging
   2. Extraoral site
      1. Iliac crest
         1. Disadvantage: it causes root resorption
         2. Bone marrow aspiration biopsy for anaemia is taken from posterior iliac crest
2. Allograft
   1. Obtained from cortical Bone
   2. Subsequently grounded to particle size of 250-750 micrometer & FDBA is formed
   3. FDBA (Freeze Dried Bone Allografts)
      1. Not Demineralised More radiopaque Osteoconductive indication: Bone augmentation ( Implant) Less BMP
   4. DFDBA ( Demineralised Freeze Dried Bone Allografts)
      1. Demineralised More radiolucent Rapid resorption Osteoinductive Indication: Periodontal disease ass. With natural tooth More BMP
3. Xenograft/ Heterograft
   1. Boplant : Calf Bone
   2. Kiel Bone: Calf/ Ox bone
   3. Anorganic Bone : Ox bone
   4. Bio oss : Porcine
   5. Pepgen P-15 : YUKNA
   6. Osteobiol : Porcine derived bone graft
4. Alloplast ( Synthetic Bone graft material)
   1. e.g. Bioactive glass Na & Ca salt , Phosphorous & SiO2
   2. Based on Particle Siz
      1. 1. Perioglass 90-170 micrometer
      2. 2. Biogran 300-355 micrometer
5. PDGF & GEM 21S
   1. Platelet Derived Growth Factor is a biologic mediator & acts as a stimulant for osteogenesis, when used as periodontal graft
   2. PDGF-BB is approved by FDA only for periodontal regeneration as a part of dental bone filling device GEM21 S
      1. GEM 21S uses B- Tricalcium Phosphate ( TCP) as a scaffold)
6. Others
   1. Enamel matrix proteins(EMP)
      1. Extracted from tooth buds of piglets( porcine)
   2. Emdogain
      1. Approved by FDA for periodontal regeneration
      2. Contains: 90% amelogenin + small amount of proline-rich non- amelogenins, tuftelin, tuft protein, serum proteins, ameloblastin & amelin
      3. Indicated to be used with Demineralized FDBA. Here emdogain has osteopromotive action
      4. Uses:
         1. For Deep, well contained Defects : EMD alone + coronally advanced flap
         2. Moderate to deep, Non contained Defects : EMD + graft, with a coronally advanced flap
         3. Supracrestal Defects with a shallow vertical Defect : EMD+ graft + barrier membrane, with a coronally advanced flap
7. Types of periodontal bone grafts
   1. Autogenous
      1. Derived from one’s own body, considered the gold standard
   2. Allograft
      1. Derived from genetically non identical donor of same species
   3. Xenografts
      1. Derived from different species
8. Classification on the basis of bone regeneration
   1. Osteogenesis
      1. Bone graft promotes formation of new bone by its own cells
   2. Osteoinduction
      1. Chemical process: by which Molecules contained in the graft convert the neighboring cells into osteoblast
   3. Osteoconduction
      1. Physical effect : Matrix of the graft forms a scaffold that favours outside cells to penetrate graft & form new bone
   4. Osteopromotive
      1. Promotes bone regeneration when used with other regenerating materials
         1. E.g. Emdogain when used with demineralized FDBA
9. BMP( Bone Morphogenetic Proteins)
   1. BMP + Bovine collagen as carrier is approved by FDA for periodontal regeneration, releases BMP over a period of 2-3 weeks
   2. BMP 2 has maximum osteogenic potential
   3. BMP 7 (osteogenic protein-1) & BMP-3 ( osteogenin)
   4. PDGF: proliferation factor for cells BMP: differentiating factor
10. Flap used with bone grafting : papilla preservation