Bone Grafting

Periodontal disease is the leading cause of bone loss in the oral cavity, though there are others such as ill-fitting dentures and facial trauma.  The bone grafting procedure is an excellent way to replace lost bone tissue and encourage natural bone growth.  Bone grafting is a versatile and predictable procedure which fulfills a wide variety of functions.

A bone graft may be required to create a stable base for dental implant placement, to halt the progression of gum disease or to make the smile appear more esthetically pleasing.

There are several types of dental bone grafts.  The following are the most common:

• Autogenous bone graft – In this type of graft, bone is removed from elsewhere in your mouth and implanted into another area.  Common donor sites include a recent extraction site, extra bony growths in teh mouth or from the back of the jaw bone.  
  
  
• Allograft – Human bone (cadaver bone) can be obtained from a bone bank and used to add bone material into defects in the mouth.  Ample bone can be obtained and no second surgical donor site is necessary. 
• Xenograft – This is bone from aniamal sources, usually bovine (cow) bone.  A xenograft is perfectly safe and has been used successfully for many years.  Ample bone can be obtained and no secondary donor site is necessary.

Reasons for bone grafting

There are a wide variety of reasons why bone grafting may be the best option for restoring the jaw bone.

Periodontal Bone Defects - Bone can be grafted into bone defects around teeth that have been had bone loss due to periodontal disease.  This graft will allow the patient's own bone to grow and fill in the bone defect helping to add more support to the involved tooth.

Dental implants – Implants are the preferred replacement method for missing teeth because they restore full functionality to the mouth; however, implants need to be firmly anchored to the jawbone to be effective.  If the jawbone lacks the necessary quality or quantity of bone, bone grafting can strengthen and thicken the implant site.

Sinus lift – A sinus lift is a procedure that elevates the floor of the sinus by placing bone graft material into the sinus which will allow dental implants to be securely placed.

Ridge augmentation – Dental bone can be deformed  due to trauma, injury, birth defects or severe periodontal disease.  The bone graft is used to fill in the ridge and make the jawbone a more uniform shape.

What does bone grafting treatment involve?

Bone grafting material needs to either be harvested from the patient or ordered from a bone bank. The gum tissue is opened around the affected site and the bone grafting material is placed.  The bone grafting process may be aided by:

• Bone tissue regeneration – A thin barrier (membrane) is placed below the gum line over the grafting material.  This barrier creates enough space for healthy tissue to grow and separates the faster growing gum tissue from the slower growing fibers.  This means that bone cells can migrate to the protected area and grow naturally.
  
  
• Tissue stimulating proteins – Enamel matrix proteins are present during natural tooth development.  These proteins can be used to stimulate bone growth in an affected site.  Tissue stimulating proteins help to create lost support in areas affected by periodontal defects.
  
  
• Platelet-rich growth factors –A high platelet concentration liquid can be used to create a blood clot at the site of a wound.  It has recently been discovered that PRGF also stimulates bone growth – meaning a denser graft in a shorter time period.

The gum is sutured in place and a follow up appointment will need to be made within 10 days to assess progress.  Bone grafting is a highly successful treatment and a good base for further periodontal restorations.

If you have any questions about bone grafting, please ask your dentist.