Bone grafting or socket preservation is often closely associated with dental restorations such as dental implants. In the majority of cases, the success of an implant procedure can hinge on the height, width and density of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended to ensure a successful implant.
There are several major factors that affect jaw bone volume:
Periodontal Disease – Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
Tooth Extraction – Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site during the following three years. Loss of bone results in what is called a “bone defect”.
Injuries and Infections – Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.
Reasons for bone grafts
Bone grafting is a highly successful procedure in most cases. It is also a preferable alternative to having missing teeth, diseased teeth, or tooth deformities. Bone grafting can increase the height or width of the jawbone and fill in voids and defects in the bone.
There are essentially two basic ways in which bone grafting can positively impact the health and stability of the teeth:
Jaw Stabilization – Bone grafting stabilizes and helps restore the jaw foundation for restorative or implant surgery. Deformities can also be corrected and the restructuring of the bone can provide added support.
Preservation – Bone grafting can be used to limit or prevent bone recession following a tooth extraction, periodontal disease, or other invasive processes.
Initially, the dentist will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. If periodontal disease is present or the adjacent teeth are in poor condition, these factors will be fully addressed before the bone grafting procedure can begin. The dentist will also recommend panoramic x-rays in order to assess the precise depth and width of the existing bone. On occasion, a CAT scan may be recommended to determine the bone condition. Depending on these results, the dentist may also anesthetize the area and explore into the gum in order to determine what kind and how much bone is required.
What Does Bone Grafting Involve?
There are several types of bone grafts. Dr. Alexander prefers mineralized freeze dried donor bone because it provides a predictible result. This is fine granules highly processed from a lab. Occasionally synthetic bone is used; however the donor bone consistently provides the best result. Dr. Alexander will determine the best type for your particular condition.
The bone grafting procedure can often is quick and safe. Immediately following the extraction the socket or recipient site is prepared to receive the bone granules. The granules are placed and packed into the socket and covered with collagen to protect the site and aid with healing. A suture is skillfully placed to secure the collagen over the site. Site preparation also stimulates additional natural bone growth. The donor bone will fuse with the growing bone and the migration of cells will cause firm adhesion and cell growth. Supplementing the jaw with bone will result in greater bone mass to help support and anchor the implant(s).
Prior to the procedure, you will be asked to rinse with a antibacterial mouthwash and then you will be seated. Dr. Alexander will numb the grafting and extraction site. You will be provided with comprehensive instructions for your post-operative care. Dr. Alexander may prescribe medications to help manage infection, discomfort and swelling. Sutures are typically removed within two weeks. Antibiotics are usually given before the procedure to help with early stage integration of the new bone. Usually several months of healing time is required before an implant can be placed.