Bone Grafting
Bone grafting is often closely associated with dental restorations such
as bridge work and dental implants. In the majority of cases, the success
of a restoration procedure can hinge on the height, depth, and width of
the jawbone at the implant site. When the jawbone has receded or sustained
significant damage, the implant(s) cannot be supported on this unstable
foundation and bone grafting is usually recommended for the ensuing restoration.
There are several major factors that affect jaw bone volume:
-
Periodontal Disease – Periodontal disease can affect and permanently damage the jaw
bone that supports the teeth. Affected areas progressively worsen until
the teeth become unstable.
-
Tooth Extraction – Studies have shown that patients who have experienced a tooth
extraction subsequently lose 40-60% of the bone surrounding the extraction
site during the following three years. Loss of bone results in what is
called a “bone defect”.
-
Injuries and Infections – Dental injuries and other physical injuries resulting from a blow
to the jaw can cause the bone to recede. Infections can also cause the
jaw bone to recede in a similar way.
Reasons for bone grafts
Bone grafting is a highly successful procedure in most cases. It is also
a preferable alternative to having missing teeth, diseased teeth, or tooth
deformities. Bone grafting can increase the height or width of the jawbone
and fill in voids and defects in the bone.
There are essentially two basic ways in which bone grafting can positively
impact the health and stability of the teeth:
Jaw Stabilization – Bone grafting stabilizes and helps restore the jaw foundation
for restorative or implant surgery. Deformities can also be corrected
and the restructuring of the bone can provide added support.
Preservation – Bone grafting can be used to limit or prevent bone recession following
a tooth extraction, periodontal disease, or other invasive processes.
Oral Examination
Initially, the dentist will thoroughly examine the affected area in order
to assess the general condition of the teeth and gums. If periodontal
disease is present or the adjacent teeth are in poor condition, these
factors will be fully addressed before the bone grafting procedure can
begin. The dentist will also recommend panoramic x-rays in order to assess
the precise depth and width of the existing bone. On occasion, a CAT scan
may be recommended to determine the bone condition. Depending on these
results, the dentist may also anesthetize the area and explore into the
gum in order to determine what kind and how much bone is required.
What Does Bone Grafting Involve?
There are several types of bone grafts. Your dentist will determine the
best type for your particular condition.
Autogenous Bone Graft - Harvested from the patient’s own body (usually from the posterior
part of the lower jaw or the chin). This method is usually preferred because
it produces the most predictable results.
Allograft Bone Graft - Cadaver or synthetic bone is used in this type of graft.
Xenograft - Cow bone is used in this type of graft.
The bone grafting procedure can often take several months to complete.
Bone is typically harvested from your own body (or on rare occasions obtained
from a “bone bank”) and added to the affected site. This bone
will fuse with the existing bone and the migration of cells will cause
firm adhesion and cell growth. Supplementing the jaw with bone will result
in greater bone mass to help support and anchor the implant(s).
During the surgery, the dentist will numb the grafting and extraction sites
using local anesthetic. A small incision will be made to prepare the site
for the new bone and it will be anchored into place. On occasion, a synthetic
membrane may be used to cover the new bone. This membrane prevents soft
tissue and bacterial invasions, and encourages new bone growth. The surgery
does not require an overnight stay, and you will be provided with comprehensive
instructions for your post-operative care. The dentist will prescribe
medications to help manage infection, discomfort and swelling.