Dental bone grafting: procedure and patient benefits
By: Dental Holistix
Bone grafting is a dental treatment designed to restore bone volume and provide support for dental implants. When bone loss occurs—whether due to injury, infection, natural resorption after tooth loss, or periodontal disease—bone grafting can help regenerate the bone and maintain the structure needed for dental restorations.
When is bone grafting necessary?
A person may need a dental bone graft for several reasons, all of which aim to restore and maintain the structural integrity and health of the jawbone. Some of these reasons include:
1. Tooth loss and dental implants
Bone Resorption: When a tooth is lost, the bone that once supported it will begin to deteriorate or resorb because it’s no longer stimulated by chewing forces.
Preparation for implants: To place a dental implant, a certain amount of bone is necessary to anchor the implant securely, and adequately seal it off from the bacteria of the oral cavity. If bone loss has occurred, a bone graft can rebuild the bone to support the implant.
2. Gum disease
Severe gum disease (periodontal disease) can lead to significant bone loss around the teeth. Bone regeneration with grafting materials (after the disease has been treated, can in some situations help regenerate this lost bone, improving overall oral health and stability.
3. Injury or trauma
Injuries to the mouth where a tooth is knocked out or damaged and then subsequently becomes abscessed can cause surrounding bone loss or damage. Bone grafting can repair these defects and restore the bone to its original state, creating the ideal structure for implant placement.
4. Dental bridges
When placing dental bridges, it is ideal to place bone graft materials into a tooth socket after extraction. This preserves the bony architecture underlying the prosthetic tooth of the bridge, which is important to create an aesthetic result and prevent a big bony defect that causes food impaction und4er the bridge.
5. Congenital conditions
Some individuals are born with missing teeth or jawbone deficiencies. Bone grafting can correct these developmental issues and provide a strong foundation for future dental work. An example of this is a cleft palate that extends through the ridge of alveolar bone supporting the teeth.
6. Stability for orthodontics
For some orthodontic treatments, adequate bone structure is necessary to move teeth into proper alignment. In situations where there is a very thin bony profile surrounding the teeth, alignment of the teeth can result in lack of bone coverage of the teeth and gum recession. Bone grafting can provide the necessary support for these treatments.
7. Aesthetic concerns
Bone loss can lead to changes in support of the teeth and the surrounding gums. This commonly results in teeth looking excessively long and asymmetry in gum levels. Bone grafting in conjunction with soft tissue (gum) grafting can help restore symmetry and aesthetics.
The types of bone grafts that exist
1. Autografts (autogenous bone grafts)
Bone is harvested from the patient’s own body, typically from the lower jaw around the wisdom tooth region.
Advantages: High compatibility, and contains live cells that promote natural bone growth. This is often considered the gold standard for bone grafting. Disadvantages: Requires a second surgical site, which can significantly increase the risk of complications and patient discomfort.
2. Allografts
Bone is sourced from a human donor, typically from a cadaver, and processed to ensure safety and sterility. Advantages: No need for a second surgical site on the patient, widely available, and effective for a variety of grafting needs. Disadvantages: Even though this is completely safe and provides very good results, many people do not like the thought of bone donated from another person.
3. Xenografts
Bone that is derived from another species, commonly bovine (cow) or porcine (pig). At least one prominent European manufacturer derives this from New Zealand cows. Advantages: Abundant supply and effective in providing a scaffold for new bone growth. Disadvantages: Some varieties take a long time to break down in the body and do not become completely replaced with host bone- which can be an issue if the bone is being relied upon to grow onto and support a dental implant. Also there are no growth factors present like in the autogenous bone, so in larger volumes it is more difficult to ensure this is completely replaced with new bone.
4. Alloplasts
Made up of synthetic materials, such as hydroxyapatite, tricalcium phosphate or bioactive glass. Advantages: Minimal cost for the material itself, and easily accessible. Disadvantages: May not integrate as seamlessly with natural bone as biological grafts and is definitely less effective in promoting bone growth.
5. Composite grafts
A combination of different types of graft materials, such as mixing autografts with allografts or alloplasts. Advantages: Combines the benefits of various materials to optimise bone growth and integration. Disadvantages: Complexity in preparation with increased costs and can be more technique sensitive in surgical management.
Our choice for bone grafting
At Dental Holistix, we specialise in using autografts, and xenografts for bone grafting treatments. When using autografts, we prefer the lower jaw (ramus) as a donor site due to its accessibility and reduced surgical complexity. For xenograft treatments, we use BioOss, a renowned bone graft material derived from cows in New Zealand and Australia. BioOss is widely recognised as the most effective and widely used substance worldwide for promoting bone regeneration. Here’s why we trust BioOss:
1. With over 30 years of clinical use and numerous scientific studies, BioOss has a long track record of safety and effectiveness.
2. BioOss closely resembles human bone in structure and composition, making it easier for the patient’s natural bone to integrate with it.
3. Known for its high success rates in bone grafting, BioOss is a reliable choice for our patients.
The bone grafting process
Before your treatment begins, Dr Nick Williams will conduct a thorough evaluation to assess your condition and determine the most suitable type of bone graft for your needs. Here’s a step-by-step outline of what you can expect during the treatment:
1. Dr Williams will review your medical history and perform a comprehensive examination to determine the best approach for your bone graft.
2. To ensure your comfort throughout the procedure, local anaesthesia will be administered to numb the treatment area.
3. A small incision will then be made in the gum tissue at the surgical site, allowing access to the underlying bone.
If autograft is used:
4. Using specialised instruments, Dr Williams will harvest a small amount of bone from a donor site in the back of your mouth- around the area of the wisdom teeth.
5. The harvested bone is then carefully placed into the prepared area at the surgical site to promote natural bone growth and integration.
6. Once the graft material is in place, the incision will be closed using sutures
If xenograft is used:
4. BioOss, a proven bone grafting material derived from bovine sources, will be carefully placed into the prepared area at the surgical site. This material serves as a scaffold to support new bone growth.
5. Once the graft material is in place, the incision will be closed using sutures or tissue glue to facilitate proper healing.
Recovery and aftercare
For both types of grafts, you will receive detailed aftercare instructions to follow at home. This may include guidelines on managing discomfort, maintaining oral hygiene and adhering to dietary restrictions to support healing.
You may experience some discomfort, for which pain medication may be prescribed. Maintain good oral hygiene by gently brushing your teeth and using an antimicrobial mouthwash as directed. Follow any dietary restrictions provided to promote healing and avoid strenuous activities that could disrupt the surgical sites. For autografts, also pay attention to care at the donor site. Attend follow-up appointments as recommended to monitor healing progress and ensure the graft integrates properly.
If you’re dealing with bone loss or considering dental implants, bone grafting might be the right solution for you. Contact us today to learn more and see how we can help you achieve a healthier smile.