Bone Grafting

Bone grafting is a procedure to rebuild lost bone tissue, often needed before placing dental implants or to halt the progression of gum disease.

Periodontal disease is the leading cause of bone loss in the oral cavity, though other factors like ill-fitting dentures and facial trauma can contribute. The bone grafting procedure is an excellent way to replace lost bone tissue and encourage natural bone growth. Bone grafting is a versatile and predictable procedure that fulfills a wide variety of functions.

A bone graft may be required to create a stable base for dental implant placement, halt the progression of gum disease, or make the smile more aesthetically pleasing.

Common Types of Bone Grafting:

  • Autogenous bone graft: Bone is removed from elsewhere in the body and implanted in the mouth. Common donor sites include the iliac section of the pelvis, chin, and the posterior third molar areas of the jaw. For large amounts of bone, the hip or shin bone (tibia) is generally used.
  • Allograft: Synthetic bone (man-made) is created in the laboratory for use in bone grafting. Bone can also be obtained from a bone bank (cadaver bone).
  • Xenograft: Involves the implantation of bovine (cow) bone. Xenografts are safe, widely used, and do not require a secondary donor site.

Reasons for Bone Grafting

Bone grafting may be the best option for restoring the jawbone, particularly when preparing for dental implants.

There are a wide variety of reasons why bone grafting may be the best option for restoring the jawbone:

  • Dental Implants: Implants are the preferred method for replacing missing teeth because they restore full mouth functionality. However, implants need to be firmly anchored to the jawbone to be effective. If the jawbone lacks the necessary quality or quantity of bone, bone grafting can strengthen and thicken the implant site.
  • Sinus Lift: A sinus lift involves elevating the sinus membrane and grafting bone onto the sinus floor, allowing implants to be securely placed.
  • Ridge Augmentation: Ridges in the bone can occur due to trauma, injury, birth defects, or severe periodontal disease. The bone graft fills the ridge and makes the jawbone a uniform shape.
  • Nerve Repositioning: If the inferior alveolar nerve needs to be moved for implant placement, a bone grafting procedure may be necessary. This nerve provides sensation in the lower chin and lip.

What Does Bone Grafting Treatment Involve?

Bone grafting is a straightforward procedure usually performed under local anesthesia, though general anesthesia may be needed for large grafts.

Bone grafting is a fairly simple procedure that can be performed under local anesthetic. However, if large amounts of bone need to be grafted, general anesthetic may be required.

  • Procedure Steps:
    1. The grafting material is either harvested or prepared for insertion.
    2. A small incision is made in the gum tissue, which is then gently separated from the bone.
    3. The bone grafting material is placed at the affected site.

The bone regeneration process may be aided by:

  • Gum/Bone Tissue Regeneration: A thin barrier (membrane) is placed below the gum line over the grafting material. This barrier allows healthy tissue to grow by separating faster-growing gum tissue from slower-growing bone fibers, enabling natural bone cell migration.
  • Tissue Stimulating Proteins: Enamel matrix proteins, like Emdogain, are applied to the graft site before suturing. These proteins mediate the formation of acellular cementum, promoting periodontal attachment.
  • Platelet-Rich Growth Factors: A high concentration of platelets is used to create a blood clot at the graft site. PRGF has been shown to stimulate faster and denser bone growth.

The gum is sutured in place, and a follow-up appointment is typically scheduled within 10 days to assess progress. Bone grafting is a highly successful treatment and provides a strong foundation for further periodontal restorations.

For any questions about bone grafting, please ask your dentist.