Over time, when patients suffer from missing teeth, misalignment, gum disease, tumor surgery or even trauma, the jawbone can shrink, atrophy and resorb. This loss of jawbone may lead to problems with the remaining teeth, an altered facial appearance and eventually the inability to speak or eat normally. Because of the poor quality or quantity of the bone, patients are often not suitable candidates for dental implants. Bone grafting can repair or replace the bone, promote new bone growth and restore its structure. This not only allows us to place implants of the proper length and width but also prevents future bone loss and improves functionality and esthetic appearance.
Types of Bone Grafts
- Autogenous Bone Grafts (autografts): Autografts are made from your own bone that’s taken from somewhere else in your body. The bone is usually harvested from the chin, jaw, lower leg bone, hip or the skull. The main benefit is the graft material is live bone and contains living cellular elements that enhance bone growth.
- Allogeneic Bone Grafts (allografts): Allogeneic bone is harvested from a cadaver and then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogeneic bone cannot produce new bone on its own. Instead, it serves as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the void.
- Xenogeneic Bone Grafts (xenografts): Xenogeneic bone is harvested from the non-living bone of another species, usually a cow. The bone is processed at extremely high temperatures to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenografts serve as a framework for bone from the surrounding area to grow to fill the defect or void.
Allogeneic and xenogeneic bone grafts have the advantage of not requiring a second procedure to harvest your own bone. This allows for a quicker recovery with less postoperative discomfort and potential complications.
Allograft Materials
As a substitute to using autogenous bone, a variety of allogeneic materials are available. These safe and proven alternatives include:
- Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA): This product is processed allograft bone, containing collagen, proteins and growth factors extracted from the bone. It’s available in powder, putty, chip or gel form. The gel form can be injected with a syringe.
- Graft Composites: Graft composites consist of other bone graft materials and growth factors that capitalize on the benefits of the various substances. Some combinations include: collagen/ceramic composite, which closely resembles the composition of natural bone, DBM/bone marrow cells, which aids in the growth of new bone, or collagen/ceramic/autograft composite.
- Bone Morphogenetic Proteins (BMPs): Bone morphogenetic proteins are proteins naturally produced in the body that promote and regulate bone formation and healing.
Allogeneic materials have the advantage of not requiring a second procedure to harvest the bone, which reduces operative risk and postoperative pain. Each bone grafting option has its own risks and benefits. We will discuss your options and together determine the type of bone graft material that’s right for you during your consultation.
Benefits of Bone Grafting
Allows for Restorative Treatments
Bone grafting enhances the jawbone’s volume, strength and stability so we can successfully perform dental implant surgery.
Improves Facial Appearance
Rebuilding the bone and replacing missing teeth will restore your normal facial contours and features and smooth wrinkles around the mouth giving you a more natural and youthful smile.
Boosts Function and Health
Bone grafting procedures will enable us to place implants in an ideal location allowing you to chew and speak normally again by replacing your missing teeth as well as preventing further bone loss.
Treatment Considerations
The surgical complexity and recovery time will depend on the type of bone augmentation procedure you undergo. Common procedures include:
Minor Bone Augmentation
We can often repair single or multiple implant sites that have inadequate bone structure due to previous tooth removal, temporary tooth replacement treatments, gum disease or injury with a simple, outpatient procedure such as:
Socket Grafting:
When teeth are extracted, the bone that holds the teeth in place (the socket) can be damaged by disease or infection resulting in deformity of the jaw. Additionally, the surrounding bone and gums can shrink and recede quickly after the extraction, which causes jaw bone defects and collapse of the lips and cheeks. This bone loss can create major challenges when trying to perform restorative dentistry. Socket grafting prevents these deformities from occurring after tooth removal. There are several techniques we can use to preserve the existing bone and minimize additional bone loss. The most common method is performed at the time of tooth removal. The empty socket is filled with bone particles and then covered with a collagen membrane stimulating your body’s ability to repair the socket. This prevents the shrinkage and collapse of the surrounding gum and facial tissues. The newly formed bone provides a foundation for an implant to replace the tooth.
Ridge Augmentation:
The alveolar ridge of the jaw is the bone that surrounds the roots of the teeth and when a tooth is removed, an empty socket is left behind. Over time, the unsupported bone will deteriorate and the height and width of the ridge will decrease. A ridge augmentation can help recreate the natural contour of the gums and jaw and also provide the bone support structure needed to accommodate dental implants. Ridge augmentation is accomplished in a variety of ways depending on the size and location of the bony defect.
Sinus Lift:
A sinus lift is used to add bone to the posterior upper jaw at the floor of the maxillary sinuses in the area of your molars and premolars. Learn More
Major Bone Augmentation
To repair large defects in the jaw, typically caused by trauma, tumor surgery or congenital defects, we usually use the patient’s own bone. Depending on the size of the defect, the most common donor sites are the hip (iliac crest), the skull (cranium), and lateral knee (tibia). We harvest the bone under general anesthesia in an operating room setting. Major bone grafting often involves a overnight hospital stay.
Pre- & Post-Operative Care Instructions