The bone growing concept: A call for a paradigm shift in bone reconstruction

Alveolar bone reconstruction has significantly evolved over the years. The transition from bone transfer techniques to bone regeneration methods aimed to reduce morbidity, increase the available reservoir of bone, and enhance volumetric outcomes. However, current bone regeneration techniques are prolonged and yield suboptimal biological results. This is primarily because the process relies heavily on bone substitutes that lack osteoinductive or osteogenic properties, with the supply of cells and growth factors entirely dependent on endogenous sources. This article calls for a new paradigm shift, proposing a biological approach for more controlled bone growth by the incorporation of exogenous cells and growth factors into a bone-growing process, thereby enhancing biological outcomes over time. Additionally, it presents a biomorphometric clinical algorithm to tailor treatment protocols for various types of bone loss.