Clinical applications of composite intramembranous bone grafts.

The aim of this article is to introduce the composite intramembranous bone graft mixed with demineralized bone matrix to the clinician and to demonstrate its various clinical applications in the field of clinical orthodontics in the form of case reports. Understanding the mechanism of healing of this composite bone graft provides sound experimental precedent that allows this graft material to become a predictable part of our future orthodontic management. The cases highlighted here took advantage of the several properties of the composite intramembranous demineralized bone matrix graft. An accidental loss of the buccal plate of bone occurred during extraction of a buccally placed premolar for orthodontic purposes. The defect was repaired using chin bone mixed with demineralized bone matrix, and the teeth were successfully moved into the grafted area. A 5-year follow-up showed a stable gingival condition at the grafted area. In this report, ridge augmentation with intramembranous demineralized bone matrix as an adjunct to orthodontic treatment allowed successful placement of endosseous implants. In conclusion, the same graft material was successfully used in the repair of a massive alveolar cleft. Long-term follow-up of these cases showed that this graft is a promising graft material that could be integrated into our orthodontic practice.