- by Dr. Karanjit Dhillon
- February 23, 2023
Dental implants have fast become one of the most preferred tooth replacement options not only for dentists but also for patients. However, as the popularity of the treatment has increased, there also has been a rise in the failure of dental implants. This has made dentists focus on the techniques and ways to improve the success rate of dental implants. Bone grafting is one of the most trusted techniques that is reckoned to increase the success rate of dental implants.
If you are planning on getting a dental implant or implants you should know and learn more about the bone grafting procedure. For dental implants to be inserted into the jawbone, a surgical procedure is needed, making it important for a person to have enough bone to support the implants. However, in some cases, the patients may have a jawbone that is too soft or thin to support the implant and the strong pressure that the chewing action of the mouth puts forth on the bone. This can cause the surgery to be unsuccessful.
In such cases, some additional procedures like a bone graft can be recommended by the surgeon to create a solid foundation for the implant.
What is bone grafting?
Bone grafting is a technique used to correct or fix issues with bones & joints where a transplanted bone helps in rebuilding and repairing the damaged or diseased bones. This bone in the jaw is regenerated or restored in absence of sufficient bone to support the implant. Bone additives and growth factors are used to strengthen the bone and achieve desired results. Surgeons use various kinds of bone graft materials for the purpose.
What is the Bone graft procedure like?
The oral surgeon can use bone sourced from the patient’s own body for example from the back, lower jaw, hip, chin, or shin. In some cases, processed bone graft material from cadavers, cows, or horses or synthetic bone grafts can be used too.
After performing the CT scan of the area where the bone is to be put, the patient is sedated for the procedure using a local anesthetic. During the procedure, an incision is made in the gum tissue above the bone-deficient area by the surgeon. A flap is created to make the bone visible. The amount of bone to be replaced is identified by the surgeon.
Another incision is made to extract the bone if it is to be taken from another area of the body. The grafting material is then placed and then stitched up.
A titanium screw is used to put grafted bone on the jawbone. The gum tissue is then stitched back into position to protect and cover the surgical area. These stitches dissolve within a few weeks.
The transplanted bone takes around two months to eventually grow into a new, strong bone. The success of the bone graft is measured by the strength it lends to the jawbone to support an implant. The next phase of the dental implant procedure can start after the completion of this procedure. Most bone grafts generally take 4 to 6 months to completely form and to be ready for dental implant placement. However, Bone grafting and implant placement can sometimes be done on the same day.
Why do you need bone grafts for dental implants?
The bone that holds your teeth known as the alveolar bone ridge begins to get reabsorbed as soon as you lose your teeth. Around 25% of the underlying bone can get reabsorbed and disappear in the body within 12 months of tooth loss. Thus the longer the gap between the tooth loss and getting dental implants, the more likely it is for the bone to shrink sizably, no longer being capable to support the dental implants.
The bone graft can help you to be eligible for dental implants if your supporting bone is too thin, too soft, or too short. Other factors that need bone grafting besides reabsorption of the bone include the existence of bony defects that can be an outcome of trauma or infection. Thus a bone graft can help in the strategic placing of the implants for both functional and aesthetic reasons.
The growth of the new bone helps to provide strength to the grafted region by creating a bridge between the graft material and the bone that already exists. Much of the grafted material is replaced by the new bone growth over time. Many other techniques can fix bone-related problems too.
The oral surgeon at Morgan Hill Dentistry can advise you whether you will need a bone graft or not to get dental implants.
Sometimes if your dentist deems fit, temporary teeth, like a bridge or a denture can be worn while waiting for the bone graft to take hold. This will help you avoid a gap in your teeth while waiting.
What are other types of bone grafts?
Other types of bone grafts can be done in specific situations besides regular bone graft surgery for a dental implant. These include:
- Sinus lifts: These are usually performed when the back of the upper jaw lacks enough bone for implants and the bone needs to be grafted to increase its height. The maxillary sinus is slightly raised during the procedure allowing room for the extra bone that is being added.
- Ridge expansion: This can help to widen the jawbone’s alveolar ridge if it is too thin. A specialized dental saw is used by the dentist to cut along the top of the alveolar bridge and the canal thus created is filled with the bone grafting material. The implants can be placed immediately after the procedure or the periodontist may wait for a few months for the jawbone to heal.
- Bone augmentation: This procedure is performed in the case of a bone that is too short. A piece of bone is attached to the bone that needs to be extended, enlarged, or made taller.
What are the Requirements for an Ideal bone graft?
There are a few conditions needed for a bone graft to be successful:
- Presence of Osteoblasts at the site: Osteoblasts help to create new bones. To ensure the success of the bone graft, the graft matrix must contain or encourage the population of osteoblasts. An insufficient number of osteoblasts can lead to the graft failing.
- Sufficient Blood supply for nourishment: A bone graft is a process of regeneration and rebuilding and not just repair. It is a biological process where the form and function of the tissue are also regained, along with the tissue itself. Thus a good blood supply to the graft as well as to the surrounding tissue is needed for the process. The blood is also needed for clot formation and cell viability. The clot is the initial matrix where the cells migrate and act as anchors for the osteoblasts.
- Stabilization of graft during healing: Mechanical stresses on the graft can lead to disruption of the blood clot during the healing, causing fibrous tissue to fill the defect instead of bone interfering with the true regeneration process. Fixation devices, like guided bone regeneration (GBR), collagen membranes, a titanium mesh, and bone screws may be used by your periodontist for the same.
- No tension in the soft tissue: As the bone is the slowest-growing tissue, GBR is established on the divergence of the bone graft from the surrounding soft tissue. It helps to keep the faster-growing tissues, like epithelium, fibrous tissue, or gingival connective tissue out of the defect to allow controlled regeneration along with vital bone formation. The bone graft material growing into the defect prevents the destruction of the collagen membrane and also acts as a site for the generation of new bone and a medium for the growth of blood vessels and osteoblasts.
A word from Morgan Hill Dentistry
The bone grafting procedure requires enormous skill and precision. It is extremely important to see an expert and experienced periodontist for the bone grafting procedure. At Morgan Hill Dentistry, while we use years of experience, we also make sure that we are abreast with all the latest studies. Our dentists are extremely skilled in carrying out bone grafting. Our team works closely with the patient from the very first consultation to discern the type of bone graft that will work best for the specific case. We make an extra effort to ensure your comfort and to make sure that your graft surgery is as painless and smooth as possible, both during and after the procedure.
If you are looking to get bone grafting surgery done in or around Morgan Hill, then look no further. We assure you that Morgan Hill Dentistry is the best choice you will make. We believe in going the extra mile to keep our patients smiling with confidence!
For more information about bone grafting and other dental procedures and solutions, consult.