Bone Grafting Guide
Dental bone grafting is an innovative oral procedure to restore proper bone density and prepare the jaw for future dental implants. Dental implants are an effective and permanent solution to missing teeth that can restore the smile. For patients to be eligible for dental implants, they need proper bone density.
If patients do not have proper bone density, they cannot receive dental implants. In this case, an oral surgeon may recommend a dental bone grafting to rebuild the missing bone, allowing patients to be potential candidates for future dental implants. Learn more about our dental bone grafting guide.
What Is Bone Grafting?
A dental bone graft is an oral surgery procedure that uses a bone transplant or bone grafting material to rebuild damaged, diseased or unhealthy bone. Dental bone grafting can help add density and volume to the bones where bone loss or resorption has occurred. Jaw bone grafting is often needed before receiving dental implants.
Bone grafting helps build a strong, stable foundation for dental implants, allowing the implants to anchor securely in the regenerated bone. Some patients may need a dental bone graft if bone loss negatively impacts adjacent teeth' health. After a dental bone graft is placed, it occupies a space, allowing your body to repair the bone and heal.
Think of a dental bone graft like a scaffold in the sense that it provides a structure where your body's own bone tissue can generate and grow. A dental bone graft may also be combined with platelet-rich plasma (PRP), a sample taken from your own blood to promote tissue regeneration and healing.
Some of the most common benefits of bone grafting include:
- Promotes proper jaw health: One of the most important aspects of a dental bone graft is that it can promote proper jaw health and bone regeneration. Without stable, healthy jawbone, patients are at risk for numerous oral complications.
- Prepares patients for future dental implants: If patients are looking for dental implants, they will need adequate bone density to support these implants. If a patient does not have healthy bone density, a dental bone graft can help make them eligible for future dental implants.
- Support the teeth: Periodontal disease can cause infections that erode the bone under the teeth, leading to loose teeth that are more prone to falling out. A periodontal bone graft places bone grafting material to stabilize the tooth and provide additional support.
Reasons You May Need a Bone Graft
Proper bone density is essential for your oral health. If you are experiencing bone loss or resorption, you may want to consider a bone graft to restore proper bone density. Adequate bone density is necessary for general good health and is often a prerequisite for various dental procedures, including dental implants.
Some of the most common reasons you may need a dental bone graft include:
- Dental implant surgery: A missing tooth can be replaced with dental implant surgery only if a patient has proper bone density. If a patient is missing a tooth for a long time, the bone is not stimulated and may begin to disappear. If the bone mass is not strong enough to support a dental implant, a dental bone graft can help restore the bone density, providing a suitable foundation for a future dental implant.
- Crooked teeth: While crooked teeth may not be the leading cause of bone loss, it is important to note misaligned teeth can make it difficult to properly clean between the teeth, allowing bacteria to grow. Bacterial growth can lead to tooth decay, tooth loss or gum disease, increasing the risk of bone loss.
- Gum disease: As gum disease advances, the teeth may loosen, and the jawbone may begin to recede. Bacteria buildup slowly eats away at the jawbone, causing periodontal misalignment. Following a gum disease treatment, a dental bone graft can help restore proper jawbone mass.
- Jaw injury: Dental trauma or jaw injury are other common reasons you may need a dental bone graft. Dental bone grafting can restore the jawbone's function, density and mass in traumatized or damaged areas.
What Materials Are Used for a Bone Graft Procedure?
There are numerous types of bone grafting materials that are divided into four general categories — allografts, autografts, xenografts and alloplasts. Each bone graft material provides unique advantages. While allografts are the most common dental bone grafting material, understanding the details and benefits of each bone graft can be helpful.
- Allografts: An allograft is a type of dental bone graft that uses donated bone from another person. An allograft comes in many forms, including lateral ridge preservation grafts and socket grafts.
- Autografts: Autografts take the patient's existing bone from portions of the jaw or the hip. One of the most common examples of an autograft is the block bone graft, commonly used if there is significant bone damage.
- Xenografts: A xenograft uses bone grafting material donated from another animal, such as pigs, cows or even coral. A dentist may recommend a xenograft to treat certain bone defects.
- Alloplasts: Finally, alloplasts are artificial bone grafts made from various compounds, such as calcium phosphosilicate, calcium phosphate or hydroxyapatite, a mineral that is the main component of bone.
What Are the Types of Bone Grafts?
A dental bone graft is just one form of bone augmentation treatment. There are several types of bone grafting procedures that can help promote proper bone density and support future dental implants.
A few of the most popular types of bone grafting procedures include:
- Sinus lift: A sinus lift is a surgery to add bone to the upper jaw by placing bone grafting material to support the area of the rear teeth.
- Ridge expansion: Ridge expansion is a surgical widening of the ridge to create enough space for a dental bone graft or dental implant. This procedure is designed to make enough space for future dental implants.
- Socket preservation: Socket preservation uses a collagen plug or bone grafting material to preserve the area within the jaw where a tooth was removed. Socket preservation may use human bone, animal bone or synthetic material.
- Distraction osteogenesis: Distraction osteogenesis is a procedure that elongates a shorter bone by cutting it into two pieces and slowly pulling them apart to encourage new bone growth to fill the space.
What Are the Side Effects of a Bone Grafting Procedure?
Dental bone grafting is a safe, effective treatment with very few risks. That being said, any oral or surgical procedure carries some level of risk. Fortunately, when an experienced oral surgeon performs dental bone grafting, there is very little risk of negative side effects.
A patient's medical history and physiology will directly affect a person's risk level. Some of the most common side effects of dental bone grafting include gum swelling, discomfort, minor bleeding and difficulty chewing or talking.
Fortunately, your dental bone graft surgeon can provide detailed post-operative care instructions to minimize these side effects. Proper oral care following a dental bone graft can promote healing and reduce the severity of these side effects.
How to Choose a Surgeon for Your Dental Bone Graft
If you are looking for an oral surgeon for a dental bone graft, you want to ensure you pick a highly trained and well-respected professional. First, you may want to consider the formal education and training a surgeon has undergone. While education experience is important, you should also consider the procedural expertise and determine if the surgeon has a successful history of performing this procedure.
Professional affiliations are a great way to evaluate potential surgeons. An affiliation with well-respected organizations can show that the dental surgeon is committed to providing the highest level of care. You can also assess reviews about the surgeon or surgical office. Previous patient experiences can provide helpful information on what to expect.
Another important aspect to consider is if a surgeon's office accepts your insurance. It's helpful to determine how much your insurance will cover to figure out what out-of-pocket expenses you may expect. Finally, you can learn a lot about a physician by booking a consultation. When speaking with a surgeon, you should feel calm, comfortable, safe and informed.
Risks of Bone Grafting
Some side effects are common and expected as a patient heals from a dental bone graft procedure. A patient will be provided with post-operative care instructions to minimize these symptoms and promote healing. While very uncommon, more serious dental bone grafting complications may occur, making it important for patients to understand these risks.
Uncommon but possible bone grafting procedure complications include:
- Intense pain: While swelling, pain and discomfort are expected, more severe side effects may include intense or severe pain. Another possibility is pain that extends beyond the first few days and does not improve.
- Continual bleeding: Most patients experience light bleeding for a couple of hours after a dental bone graft procedure. It is important not to clean or rinse the teeth immediately after the procedure, as this may wash away the new blood clot. While uncommon, some patients may experience intense or ongoing bleeding.
- Nerve damage: Nerve damage is a serious complication following a dental bone graft that may be temporary or permanent.
- Bone graft rejection: There is a small risk that some patients may experience a dental bone graft failure, meaning their body rejected the bone graft. A patient's overall health, lack of post-operative care, oral infections and other surgical complications may increase the risk of a bone graft failure.
- Anesthesia reaction: Some patients may negatively react to anesthesia, typically feeling nauseous or sick immediately after a dental bone graft. In some cases, patients may experience longer-lasting symptoms for a few days after surgery.
Who Are Ideal Candidates for Bone Grafting?
Dental bone grafting can be performed in most adults who plan to undergo a future dental implant procedure, so long as the bone surrounding a missing tooth has proper density. Patients with certain autoimmune disorders, including diabetes, may not be ideal candidates for a dental bone graft. These disorders may impair healing.
Patients with periodontal disease will require a gum disease treatment before being eligible for dental bone grafts. Unfortunately, patients who smoke regularly or excessively are likely not ideal candidates for dental bone grafting, as their chances of graft rejection or severe complications are much more likely. Any patients with uncontrolled chronic disorders, including heart disease, likely should not undergo a dental bone graft.
How to Prepare for Bone Grafting
Your dental bone graft surgeon will provide you with in-depth instructions to prepare for your procedure. In some cases, you may need to stop certain medications ahead of time, including blood thinners. It is also recommended to avoid smoking before a dental bone graft procedure to promote healing. During your consultation, you should notify your physician of all medication you take, any medical allergies and previous health information.
In some cases, you may need imaging tests, including a CAT scan, X-ray or magnetic resonance imaging (MRI). Generally, you will need to have a friend or family member accompany you to your procedure and drive you home as you continue to recover from anesthesia. You should avoid drinking or eating after midnight the night before your dental bone graft.
What Happens During a Bone Grafting Procedure?
While the details of a dental bone grafting procedure will vary from patient to patient, most dental bone graft procedures begin when anesthesia is administered to ensure patient comfort throughout the procedure. A medical professional will carefully monitor your vital signs during the procedure, including blood pressure and heart rate.
Your oral surgeon will clean the affected area and make an incision to access the bone graft site. If your surgeon uses bone from another portion of your body, another incision will be placed to collect this bone. The bone graft will then be inserted into the surgical site. The graft may need to be secured with special screws. The incision will be carefully enclosed, and the anesthesia will wear off.
What Happens After a Bone Grafting Procedure?
Your health care provider can provide you with details on what to expect following your dental bone graft during your consultation. It is normal for patients to experience pain and discomfort, but pain medications can help alleviate discomfort. Most patients can resume a normal diet shortly after surgery.
In most cases, patients are prescribed antibiotics to lower the risk of infection. Your physician may also recommend over-the-counter pain medicine or prescription medication to improve discomfort during recovery. Fortunately, most patients experience very little pain during the healing process. It can take anywhere from three to 12 months for the bone graft to fully fuse with your bone.
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