Bone Graft Types for Teeth
Multiple modalities are available to increase the bone quantity in areas where dental implant placement is desired. Most bone grafting materials are derived from bone that is harvested from either a human or an animal source. In addition to using actual bone, synthetic grafting materials may also be employed.
The type of bone grafting material chosen depends upon a number of factors including the type of surgery being performed, the age and medical history of the patient, and the quantity and quality of existing bone. A vast majority of bone grafts performed specifically for the placement of dental implants incorporate the use of either freeze-dried cadaver bone or bone transferred from within the patient’s own body.
Bone Graft Surgery for Dental Implants
Insufficient bone quantity is an obstacle to implant placement and is often the result of periodontal disease, bony defects, bone resorption after tooth removal, injury, or trauma. Bone grafting is a surgical procedure that restores both bone height and width when the patient lacks sufficient bone to properly support a dental implant in all dimensions.
Bone grafting for implants makes a big difference in the long-term success rates of dental implants and allows fixed restorations to be placed in areas where removable prosthetics were formerly the only restorative option.
Bone Grafting Dental Procedure
Bone grafting is a separate, adjunctive surgical procedure with its own unique procedure code. To avoid the need for a second surgical entry specifically for graft placement, it is often performed in conjunction with other surgical procedures or extractions. For most implant cases, the type of grafting we are talking about performing is ridge augmentation.
When bone loss has occurred in the upper posterior region, the maxillary sinuses are often positioned very near the crest of the alveolus. Augmenting bone in this area involves displacing the sinus membrane upward via a sinus lift. This type of procedure adds grafted bone that increases the distance between the floor of the sinus and the crest of the ridge, thus allowing for implant placement into solid bone.
How Does Bone Grafting Work?
Bone grafting is possible because the bone has the ability to regenerate itself completely if provided the space and structure on which to grow. The process of bone grafting has less to do with the actual type of graft material chosen and more to do with stimulating the patient’s own body to form and lay down new bone growth. The bone grafting material is present to act as a framework for the development of new bone growth, filling in voids and defects as the new bone matures.
How Is Bone Grafting Done?
The patient is anesthetized via a local anesthetic. The dental surgeon incises the tissue to access the area of treatment. Existing bone is prepared by removal of the periosteum and roughening the surrounding bone which stimulates bleeding. Small holes may be created in the existing bone that encourage bone repair and growth factors to flow to the area via the patient’s blood supply.
Typically, bone fragments in a matrix of sterile saline are used to supplement the missing bone and create a framework for new bone growth to occur. Depending upon the location, a resorbable collagen membrane may be used to help stabilize the graft for the first few days after surgery, until the body’s healing response creates a stable, clotted mass.
Many surgeons choose to over-contour the graft to account for expected shrinkage as new bone forms and heals. Once the graft material is in place, the gum tissue is sutured to keep everything stabilized.