A: Bone grafting is basically the replacing of bone where either a tooth was or where an implant needs to be. So, what we do is we basically trick the body into fixing itself and creating more bone where there wasn’t. Anytime you remove or lose a tooth the bone starts to shrink. A bone graft prevents that shrinkage from occurring.
Basically, what I try and analogize it to is if I dug two holes outside. I fill one with concrete and I let one just sit. Eventually, the hole without concrete might fill up but it may have a dip in it. So, we probably wouldn’t want to build a house on that. Whereas the hole with concrete we can put a solid structure on there.
As Dr. Vela stated, bone grafting is a workaround to increase the amount of bone needed in the jaw for an implant. It does add a significant amount of time to the dental implant process, but it makes implants possible when bone mass does not.
To graft a bone, there needs to be some bone material introduced and fused to your jawbone. In the future, 3-D printed synthetic bone material may be used as trials of 3D printed bone replacements show promise.
How Is Bone Grafting Done?
There are various ways dental bone grafting can be performed, but the basics are the same. The surgeon makes a small incision into the area of the jaw lacking mass. Then, they will attach a small sliver of bone taken from elsewhere to the site. The bone material over the next few months will automatically bond with the jaw and integrate.
The preferred source of healthy bone for bone grafting is from your hip, your tibia, or the back of your jaw. This is the most common approach and is referred to as autograft. Most dentists prefer this method as it increases bone support in the jaw and heals faster. Overall, there are four methods for dental bone grafting.
Types of dental bone grafts
- Autografts— This takes bone material from your own body usually from your hip or jaw.
- Allografts— This graft sources bone material from a donor, usually a cadaver.
- Xenografts— This approach takes material from another living thing such as a cow, pig, or sea coral.
- Alloplasts— In this unique method, synthetic material is used, usually calcium phosphate or Bioglass (calcium sodium phosphosilicate)
Who Is A Good Candidate For A Bone Graft?
There are several reasons why a patient might seek bone grafting in the realm of restorative dentistry. Whatever the reason may be, grafts make a bleak situation much more feasible and provide a reliable workaround for missing bone.
Implants For Missing Teeth
People who are needing dental implants that lack bone mass in the jaw can use bone grafts to supplement. Since dental implants are artificial root-shaped titanium screws, they need sufficient jawbone mass to properly fuse.
Tooth Loss Or Gum Disease
Even if you’re not getting dental implants, bone grafting can offer support to the jaw to mitigate bone loss. If not mitigated it will begin to negatively impact neighboring teeth and gum tissue.
Other candidates for bone grafting include people with conditions that result in jawbone deterioration. This type of bone loss is not caused by missing teeth, but a weak or soft jawbone, often caused by osteoporosis. However, while most people think that bone issues like this are only a problem for the elderly they would be wrong. In fact, a person of any age can develop osteoporosis. Also, someone who has suffered severe facial trauma could suffer jawbone weakening as well.
How Painful Is The Bone Grafting Procedure?
A bone graft that uses bone material other than your own is a fairly minor procedure. You will also be sedated during the procedure so pain during the procedure is non-existent. Once the anesthesia wears off, the pain is usually managed easily with Tylenol or Aleve.
However, if the bone material is harvested from your own body, that procedure can be a bit more painful. This is because surgery is performed in two sites, such as your hip for harvesting and your jaw for grafting.
How Do I Prepare For A Bone Graft?
There’s not much preparation needed for a bone graft as it’s not a relatively complex procedure. However, there are indeed a few things you need to do before the operation:
- Avoid food and drink for 12 hours before the procedure as the anesthesia could upset your stomach if you don’t.
- Consult with your doctor regarding the medications you are taking, especially blood thinners. Blood thinners if not taken into consideration, can complicate the procedure with bleeding issues.
- Make sure you have reliable and trustworthy transportation/caretaker to go home after. You will be groggy and unable to drive due to anesthesia.
What Is The Bone Grafting Procedure Like?
Here’s how a typical bone graft is performed. However, each case varies with different circumstances, but assuming all is the same it goes like this:
- You’ll be given anesthesia before the procedure and your vitals will be continuously monitored.
- The dental hygienist will clean the site to be grafted.
- The surgeon will make a small incision in the gum tissue to expose the bone where the graft will be placed.
- The surgeon will then position the bone material between two areas of bone that need to fuse. The graft acts as a bridge and then it all becomes one.
- The bone graft has dissolvable adhesive placed over it to secure it, sometimes special dental screws are used.
- The incision flaps are then sewn back up to let the site begin to heal.
What Is The Recovery And Aftercare Regimen?
After you get the bone grafting done, you’ll leave the office with a gauze pack around the incision inside your mouth.
You’ll be given instructions on how to change out the dressing over the next 24-48 hours. You’ll also be given a prescription for antibiotics which are critical to avoid infection. If needed, you’ll also be given a prescription for pain killers, which should be used sparingly.
Other post-surgery care tips involve:
- Placing ice packs on the site to reduce swelling and pain for the first two days or so.
- Sticking to a diet of soft foods without many spices or acidic ingredients. Bland foods such as potatoes or rice work best. Cold soups such as gazpacho are acceptable as well.
- Keep your head elevated slightly while sleeping for the first two nights to prevent blood from flooding the site. A fill extension recliner works great if you have one.
During the initial recovery period, you should avoid:
- Hot tea, coffee, soup, and other hot liquids.
- Hard or foods such as nuts, chips, and seeds, as they can get lodged in the site.
- Strenuous physical activity that might put your incision in danger such as contact sports.
After 7-10 days the dull pain should subside considerably, existing as only mild discomfort, improvement will be notable.
After some weeks have passed your jaw should feel normal again. However, it will still need a few months before it can support implants. In the meantime, make sure to plan for intermittent visits to your dentist and a round of x-rays to monitor progress.
Is Bone Grafting The Answer To Your Issue?
There’s not a long list of reasons why one would need a bone graft. The most common is to prepare your jaw for dental implants. If this is your situation you should contact us. You might find that dental implants are indeed a possibility, even if your jawbone is weakened. The only way you’ll know is to book a consultation, so contact us today!