The following list identifies factors in the selection process that can strengthen procedure outcomes. Bone grafts require a source of blood supply which is the alveolar bone lining the defect. The more bony walls that are in contact with the graft material the better the chances for a successful procedure. The graft material will have an adequate supply of blood and the bony walls will retain the graft material in place. Conversely, the more root surface that is in contact with the graft material, the poorer the prognosis of the case because blood supply is limited.
Narrow defects are better than wide defects.
On the contrary, in a very wide defect the graft material tends to spread or get washed away. The ideal osseous defect for a regenerative procedure is a 3 wall defect as seen on the distal aspect of this second molar. This defect shape will favor the stabilization of a graft material to be used. Narrow 2 wall defects are still good indications for reconstructive osseous surgery, but are not as ideal as 3 wall defects. Interproximal craters, which are common 2 wall interproximal defects, may be an indication for reconstructive osseous surgery if the defect is narrow.