What is Bone Grafting?
The long term success of a dental implant relies on having a strong, sturdy foundation of bone where the implant is placed. Fortunately for many patients, bone sufficiency and strength can be restored through bone augmentation (also called bone grafting).
Bone augmentation or grafting for dental implants involves providing sterilized bone mineral (either human or animal) to serve as a “placeholder” in the area where the implant is to be placed. During healing time, through a process called “guided tissue regeneration,” the human body responds as if the graft was natural bone and, over time, resorbs and replaces the material with the patient’s own bone.
Who Can Benefit From Bone Grafting?
There are several common reasons why someone may have insufficient bone capability, and could thus benefit from bone grafting. These reasons include:
- Dental caries (cavities) and infection
- Tooth loss with empty spaces that were left after the tooth was removed, leading to bone loss over time
- Gum disease
- Defective tooth development
- Facial trauma
- Long-term use of dentures
- Dental procedures that didn’t address the need to maintain or restore adequate bone structure
Common Bone Grafting Procedures
The first step in treatment planning for dental implants is a thorough examination. We utilize cone beam technology (CBCT scan) to create a three dimensional image. This is essentially a roadmap for treatment, and is used to immediately locate the anatomic structures, assess the ridge, and evaluate the quantity and quality of existing bone.
The three most common bone grafting procedures used in a dental implant treatment plan are:
- Ramus or Chin Graft: Using local and/or IV sedation, an incision is made to expose the chin or jaw bone near the back of the jaw. A block of bone and marrow is then removed, and the area is filled with a thin membrane, so it won’t fill in with gum tissue as it heals. The incision is then stitched closed. Next, the bone block is placed and anchored at the implant site. Another membrane is placed over the graft, and this incision is stitched closed.
- Ridge Preservation Graft: This procedure is done after a single tooth extraction, in cases of infection or discrepancy between the size of the extracted tooth and the implant. As an intermediary step, granular bone mineral product is placed in the extraction hole, along with a resorbable collagen pledget that serves as a plug for the site. The site is closed with stitches and the body naturally begins to regenerate bone in the area over a period of months.
- Sinus Lift: The procedure is for implant patients lacking enough bone in the upper jaw, or whose sinuses are too close to the jaw. An incision is made in the upper posterior area, and the sinus membrane is gently moved away from the jaw. Next, granular bone material is packed into the space where the sinus was and the area is secured with stitches. Over several months, the grafted material resorbs as natural bone regenerates in the area.