What is Bone Grafting in Dentistry?
There is little doubt that dental implants can produce some amazing results, restoring just a single tooth or multiple teeth in a way that is long-lasting and aesthetically pleasing. To ensure your treatment is successful, you may need an additional procedure, and which is to have a bone graft. If a bone graft is recommended, there is nothing to worry about as it is a standard procedure, and will simply help ensure the very best outcome for your dental implants.
Why Do We Lose Bone?
Your natural teeth are surrounded by a type of bone called alveolar bone which helps to hold them firmly in place. However, when teeth are lost or if you have severe periodontal disease, your alveolar bone can begin to diminish. When teeth are removed, bone gradually resorbs whereas with periodontal disease it is destroyed by infectious bacteria and the loss of bone can eventually lead to tooth loss. Bone resorption or loss can reduce the height and width of alveolar bone.
When Is Bone Grafting Necessary?
Often the best and most advanced way to replace missing teeth is with dental implants, where an implant post is inserted directly into the jawbone, replicating a tooth root and supporting a replacement tooth. While this treatment is regarded as being the gold standard for tooth loss, teeth must be surrounded by a certain amount of strong and healthy alveolar bone. If this bone is missing, then it must be replaced using the appropriate bone grafting or bone augmentation technique. This restores missing alveolar bone, ensuring it has the correct height, width, and contours to properly support your dental implants. Bone grafting can also help to provide better aesthetics once your missing teeth are restored.
How Will I Know If Bone Grafting Is Needed?
When you visit Ivory Dental for a consultation with our dentist Dr. Benjamin Hull, he will carefully assess the condition of your jawbone and will need to take digital dental x-rays and a CT scan. While digital x-rays produced 2-D images of your jaws, a CT scan produces highly detailed 3-D images which allow Dr. Hull to closely analyze your alveolar bone and to assess if it has sufficient mass and density. If there is insufficient alveolar bone, he will discuss the best way to restore the missing bone.
What are Some of the Different Bone Grafting Techniques?
Sometimes a bone graft will be carried out at the same time as a tooth is removed, by packing the empty socket with bone grafting material which helps to prevent bone resorption and to help preserve the bony ridge that used to hold your tooth. Another technique is used to increase the height and width of alveolar bone, sometimes by attaching a block of bone to an area where it is deficient, and this is firmly held in place with specialized fixation screws until the bone becomes fully integrated with your own alveolar bone.
One very common bone grafting technique is a sinus lift or sinus graft. This may be necessary if you wish to replace upper back teeth as the jawbone in this area is quite close to your sinuses which are empty, air-filled cavities. It’s not unusual for the bone in this area to be thinner than normal and a sinus lift is a procedure to lift the membrane in the sinus cavity, gently moving it upwards, out of the way and making room for bone grafting material to be packed into the newly created space. This will help to thicken the bone in this area.
Often bone grafts are placed using guided tissue regeneration, and where a specialized membrane is placed over the bone graft in between the bone and the gum tissue. This helps ensure that the bone grows in the correct area, so it provides the very best level of support for your gums. As the bone grows, the membrane is gradually resorbed.
When only a minimal amount of bone is required, it may be possible to place it at the same time as your implant. Other times, a bone graft is carried out as a separate procedure and you will need to wait several months for it to fully integrate with your natural bone and before it is strong enough to support a dental implant.
What Type of Bone Will Be Used?
There are three main types of bone that can be used here at Ivory Dental. The first choice is to use your own bone, a bone graft that is referred to as being autogenous. Although this does require a separate procedure to harvest the bone from another site in your body, for example, your hip, autogenous bone grafts tend to be extremely successful. The second option is to use an allograft and where bone is taken from a human donor. This bone has been extensively tested and sterilized to ensure it is safe for use. The third option is called a xenograft and is bone that is usually bovine in nature. Dr. Hull can discuss all these options with you, helping you decide which will be best for your situation. If you do have donor bone, then there is no need to worry because it undergoes extremely stringent testing. In any case, once the bone graft has been placed then it will gradually be replaced by your own bone.
Is Bone Grafting Safe?
Our Sandpoint Dental Office will also wish to assess your suitability for bone grafting, carefully considering your medical history. Sometimes certain medications or medical treatments may mean additional procedures will need to be taken during your treatment. This may be the case if you currently take bisphosphonate medications or have received radiation treatment to your head and neck area. Every precaution will be taken to ensure this treatment is safe and appropriate and if you feel a little anxious about having this procedure, Dr. Hull will discuss using additional sedation to help ensure you feel as relaxed and as comfortable as possible.
As with any surgical procedure, there is a small risk of side-effects including discomfort, swelling and bruising, but most of these can be managed with anti-inflammatory medications and pain relievers. Generally, a bone graft will not cause any significant pain, and bleeding following this procedure is usually minimal. You may be prescribed antibiotics to take just before the procedure and for a week or so afterward, to minimize the risk of any infection. When you have a bone graft you are simply ensuring your dental implant treatment has the very best chance of a successful outcome. Once completed, you can look forward to enjoying all the benefits of dental implants, including teeth that look and feel great.