By David Hudnall, DMD
Can I get dental implants if I don’t have enough jawbone? That’s a common question that dentists get asked almost every day. The answer can depend upon a number of factors, the main one being your overall health. Thankfully for many patients, it’s possible to have a bone graft procedure prior to implant surgery that helps you grow new jawbone, making it possible for dental implants to be placed.
Bone Graft Types for Teeth
There are multiple substances that can be used to increase the bone quantity in areas where dental implants placement is desired. Most bone grafting materials are derived from bone that is harvested from either a human or an animal source. In addition to using actual bone, synthetic bone grafting materials may also be employed.
The type of bone grafting material the surgeon chooses to use depends upon a number of factors including the type of implant surgery that will be performed, the age and medical history of the patient, and the quantity and quality of existing bone. The vast majority of bone graft procedures performed for placement of dental implants incorporate the use of either freeze-dried cadaver bone or bone transferred from another location within the patient’s own body.
Bone Graft Surgery for Denture Implants
Insufficient bone quantity is an obstacle to implant placement and is often the result of periodontal disease, bony defects, bone resorption after tooth removal, injury, or trauma. Bone grafting helps to restore both bone height and bone width when the patient lacks sufficient bone to properly support a dental implant in all dimensions. Bone grafting for denture implants can make all the difference when it comes to the long-term success rate of dental implants and allows crowns and bridgework or implant-supported dentures to be placed in areas where removable dentures were previously the only option.
Bone Grafting Dental Procedure
A bone graft surgery is a separate, adjunctive procedure with its own unique insurance code. To avoid the need for a second surgical entry specifically for graft placement, dental surgeons will often perform bone grafting at the same time other surgical procedures or extractions are being performed. In most implant cases, the type of grafting we’re talking about performing is ridge augmentation. Virtually any area of the jaws may require ridge augmentation if there isn’t sufficient bone to fully support a future dental implant.
One example of how ridge augmentation can be effective for implant placement involves the posterior region of the upper jaw. When teeth are removed in that area, often the maxillary sinuses are positioned very near the gum tissue, separated by only a thin layer of bone.
Augmenting the bone in this area involves moving the sinus membrane upward, known as a sinus lift. In addition to physically repositioning the sinus lining, the surgeon also adds bone grafting material to support the sinus membrane and increase the distance between the floor of the sinus cavity and the crest of the ridge. Doing this will allow an implant to be placed into the solid bone after several months of healing.
How Does Bone Grafting Work?
Bone grafting is possible because bone has the ability to regenerate itself if provided the space and structure on which to grow. The process of bone grafting has less to do with the actual type of graft material chosen and more to do with stimulating the body’s own response to form and lay down new bone growth. The bone grafting material placed is present to act as a framework for the development of new bone, filling in voids and defects as bone forms and matures.
How Is Bone Grafting Done?
The patient is numbed using a local anesthetic. The dental surgeon opens the gum tissue to access the area for treatment. Existing bone is prepared by removing the layer of periosteum covering the bone and roughening the surface, which stimulates bleeding. Then, small holes may be created in the existing bone that encourage bone repair and growth factors to flow to the area by way of the blood supply.
Typically, bone fragments mixed with sterile saline are used to supplement the missing bone and create a framework for new bone growth to occur. Depending upon the location, a resorbable collagen membrane may be used to help stabilize the graft material for the first few days after surgery, until the body’s own healing response creates a stable clot. Many surgeons will add more than the minimum amount of material to the graft area in order to account for expected shrinkage as new bone forms and heals. Once the graft material is in position, the gum tissue is sutured to keep everything in place.
Bone Graft Materials
The majority of dental bone augmentation surgeries for dental implants involve the use of either freeze-dried cadaver bone or bone taken from another area of the patient’s own mouth. A common example of using the patient’s own bone occurs when tori or exostoses (excess bony projections) that impede denture placement are removed.
Combining the bone reduction surgery with bone grafting allows the excess bone to be removed and ground. It is then transferred to supplement a deficient ridge in another location. Additional freeze-dried bone may be added to the patient’s bone if the patient doesn’t have enough excess bone to fully supplement the entire area.
Bone Graft Surgery for Teeth Healing Process
A dental bone graft surgery that doesn’t involve harvesting bone material from a location outside of the patient’s mouth is a relatively minor procedure. Post-operative pain and discomfort are usually managed with over-the-counter pain relievers.
There may be slight swelling and soreness for a few days after treatment. Antibiotics and prescription-strength pain relievers may be appropriate depending on the complexity of the surgery and the patient’s overall health.
Tooth Extraction and Bone Graft Recovery
Whether having teeth removed, a bone graft procedure, or both treatments performed during the same visit, the body slowly begins to heal and the patient will notice improvement each successive day following surgery. Usually, after the sutures have been removed, the patient has healed well enough to be able to function normally.
Dental Bone Graft Healing Stages
Once the patient gets beyond the initial trauma from surgery and sutures are removed, all of the remaining healing and remodeling takes place thanks to the osteoblastic activity of the adjacent bone. Any membrane used for stability dissolves as new bone growth is stimulated.
The matrix of added material allows bone growth to be supported and formed to completely encompass this framework. The entire healing process for the solid bone to form, suitable for implant stabilization, takes roughly four to six months.
FAQs About Dental Bone Grafting
What Is the Success Rate of Dental Bone Grafts?
Dental bone grafts enjoy an average success rate of roughly 99%.
Where Does the Bone Come from for a Dental Bone Graft?
- Xenografts use bone taken from an animal source, typically a cow or a pig. These are rarely used in ridge augmentation surgeries.
- Autografts use bone harvested from another part of the patient’s own body. In oral surgery, this typically occurs when the bone is removed from one area and is transferred to another area, either within the mouth or from a completely different second surgical site.
- An allograft involves using bone taken from a human cadaver.
- Resorbable or non-resorbable synthetic materials are used in limited circumstances.
It is always a good idea to discuss the source of grafting materials being considered with your dentist prior to treatment. Although materials used in bone grafting are proven to be safe, some patients become uneasy and have valid concerns when it comes to introducing a foreign material into their bodies.
Why Would a Dentist Do a Bone Graft?
The main reason for supplementing jawbone is to place an implant in a specific, ideal location in the near future. Bone grafting for dental implants allows implants to be placed into an area that otherwise would not have enough bone to fully support the implant.
Are Dental Bone Grafts Painful for Patients?
Generally, no. Most bone graft surgeries are performed as outpatient procedures under local anesthetic. The mouth is one area of the body that heals and recovers very quickly from surgery. After a successful surgery, any pain or discomfort will usually resolve within a few days and the patient will be back to his or her normal routine.
Is Dental Bone Grafting Safe?
The bone graft procedure is generally considered safe. Bone harvested from cadavers has been decontaminated and is free from disease. That said, like all surgical treatments, the procedure does carry some rare risks and it is possible for grafts to fail through a foreign-body reaction.
Can Bone Grafting Fail?
Failure is usually the result of a bacterial infection within the first two weeks following surgery. Typical signs and symptoms of graft failure include swelling that persists or becomes more pronounced with time, worsening pain, and drainage from the graft site itself.
The patient should contact the surgeon immediately if they experience any of these conditions. To resolve the problem, the dentist will access the graft, remove as much of the material as possible and completely debride the area. Relying on antibiotics alone to resolve an adverse reaction to a dental graft prolongs failure and patient discomfort.
Bone Grafting for Implants Increase Your Restorative Options
Bone grafting for dental implants can be a key building block for beautiful dental restorations and implant-supported dentures. European Denture Center makes it easy for you to experience all of the benefits of implant-supported dentures. Why settle for dentures that can move around when you have better long-term alternatives? Call or set up your consultation appointment online today. Open your world to dental treatment possibilities that you’ve only dreamed of!