Once a tooth has been lost due to dental decay or trauma, there can be changes to the surrounding bone that used to hold the tooth in place. If the tooth or teeth have been missing for an extended period of time, the underlying bone structure may be diminished. When too much bone has been lost, implants may not be able to be placed in the bone in its current state. Fortunately, with the implementation of various bone grafting techniques, implants can still be possible for most individuals. Bone grafting techniques allow the patient to regain bone that has been lost in order to have implants placed. Depending on the degree of bone loss, different bone grafting techniques may be necessary.
Bone Grafting What Is It And How Does It Work?
Typically, bone grafting can be categorized in the minor or major grafting.
-Minor grafting: The implant sites have areas of insufficient bone making ideal implant placement not possible. Small deficiencies can often be treated with a minimally invasive procedure that can usually be completed at the time of implant placement. This type of grafting will heal concurrently with your implant to ensure an optimal result.
-Major grafting: Large deficiencies in the jaw bone can be present due to long term tooth loss, trauma, infection, or congenital disorders. If the proposed implant site or sites do not have enough bone, various bone grafting procedures may be needed prior to implant placement. Bone grafting materials can vary from bank bone to bone from the patient’s own body, such as the posterior jawbone or the hip bone [see below for graft types]. Once the bone graft has been obtained, it is then placed in the proposed implant site, fixated in place, and allowed to heal. During this healing process, the bone graft material heals and integrates (fuses) to the surrounding bone underneath the soft tissue. This process makes the area suitable for implant placement. The bone graft healing can take up to six months or longer prior to implant placement.
Various materials can be used in bone grafting and can be categorized into four main areas:
-Autograft: Bone taken from one site in an individual’s body and moved to another site. This typically requires creating two surgical sites: one from the area where the bone graft is harvested and one where the bone graft is placed. For many oral surgery procedures, this bone is typically obtained from the back portion of the lower jaw from inside the mouth.
-Allograft: This is laboratory processed human bone (cadaver bone), from a deceased registered donor from a medical tissue bank. This type of graft acts as a framework or scaffolding for a patient’s body to grow and develop new bone over and within.
-Xenograft: This is laboratory processed bone that comes from an animal. It is typically bovine (cow) bone. This type of graft acts similar to an allograft and acts as a framework or scaffolding for a patient’s body to grow and develop new bone over and within.
-Alloplastic: These types of grafting materials are synthetic or laboratory made materials. These products are substituted instead of using real bone. One such substitute is Bone Morphogenic Protein, commonly referred to as BMP. These proteins occur naturally in the human body, and act to stimulate and regulate bone growth and healing. This material can be used to help regain bone that has been lost in an area where an implant is desired but is not amenable to implant placement in the current state.