The most common use of bone grafting is in the application of dental implants, in order to restore the edentulous area of a missing tooth. Dental implants require bones underneath them for support and to have the implant integrate properly into the mouth. People who have been edentulous (without teeth) for a prolonged period may not have enough bone left in the necessary locations. In this case, bone can be taken from the chin or from the pilot holes for the implants or even from the iliac crest of the pelvis and inserted into the mouth underneath the new implant.
In general, bone grafts are either used en block (such as from the chin or the ascending ramus area of the lower jaw) or particulated, in order to be able to adapt it better to a defect.
Another common bone graft, which is more substantial than those used for dental implants, is of the fibular shaft. After the segment of the fibular shaft has been removed normal activities such as running and jumping are permitted on the leg with the bone deficit. The grafted, vascularized fibulas have been used to restore skeletal integrity to long bones of limbs in which congenital bone defects exist and to replace segments of bone after trauma or malignant tumor invasion. The periosteum and nutrient artery are generally removed with the piece of bone so that the graft will remain alive and grow when transplanted into the new host site. Once the transplanted bone is secured into its new location it generally restores blood supply to the bone in which it has been attached.