When there is insufficient bone available for the placement of a dental implant, a bone graft is required to rebuild the area.
Bone can be lost in several ways.
- After a dental extraction, within a certain period of time the bone naturally begins to resorb (melt away).
- Difficult dental extractions can require bone removal to facilitate its removal and therefore translates into bone loss.
- Periodontal disease (chronic) leads to bone loss over time.
- Finally, cysts or tumors in the jaws can cause bone to be lost or destroyed.
Fortunately, with modern techniques the missing bone can be replaced (regenerated). The great news is that when the graft has healed and an implant is placed, signals are sent to the brain to keep the bone in the area instead of resorbing just like the natural tooth keeps bone around it over time. Grafting procedures are available for all situations in the oral cavity. Your surgeon, with the aid of advanced imaging (i-CAT 3D CT) can advise what type of graft is best for your situation.
Single tooth grafting
Very often after an extraction of if you are missing a tooth from birth (congenitally absent) there is not enough bone to place a dental implant. Before the implant is placed, a bone graft is done to build up the bone in the area. The amount of bone needed will depend on how much bone is missing. This is determined by a clinical examination and a 3D CT scan which is available to Valley Oral Surgery.
Several options for the graft material are available; your own bone (autogenous) or “bone in a bottle” – bone substitutes. Once the graft is placed, typically it takes 3-5 months to heal prior to implant placement. On occasion the graft can be performed at the same time as the implant surgery. For congenitally missing teeth, usually a block graft using the patient’s own bone is the best treatment since this type of surgery is performed in younger patients and gives a better long term prognosis.
Sinus grafting – “Sinus lift” procedure
The back part of the upper jaw is usually a difficult area to place dental implants because of the proximity of the air sinus cavities. If there is not enough bone, a graft can be placed in the lower portion of the sinus cavity often times at the same time of dental implant surgery. If the bone is so resorbed or missing, on occasion, the sinus graft is performed first, allowed to heal, then the implants are placed. (This is often seen with multiple posterior tooth replacement.)
At the time of grafting typically a special covering is placed over the graft to protect it as it heals. Over time as the graft heals this special “bandage” melts away. These membranes encourage bone healing. When the bone graft is combined with the use of a membrane it is often referred to as “guided bone regeneration.”
Today, bone grafting is a very common oral surgical procedure. As with most procedures, it can be comfortably performed under intravenous anesthesia in the office setting. These procedures carry a high degree of success. Your surgeon will review which grafting procedure will be necessary to complete your implant surgery.