Why Bone Grafts Are Needed For Dental Implants

Dental implants are a common procedure in modern dentistry. Another procedure called a bone graft, is required to aide in the stabilization of dental implants. For dental implants to be successfully integrated, the quality and quantity of bone available matters. If the bone is of poor quality or low quantity the dental implants have a far lower chance of success. Having adequate bone present is required for a dental implant to integrate (become one with the surrounding bone), and be strong enough to chew. Bone grafting is a surgical procedure that can increase the quality and/or quantity of the bone to improve the chance of dental implant success. However, not all dental implants require bone grafts. So, when do you need them?

Dental Bone Grafts For Dental Implants

– The existing bone has insufficient width. This could be a genetic condition where the bone width is lacking naturally or it could be from damage due to periodontal disease.

– The existing bone has insufficient height. The height of the bone is just as important as the width as it ensures the dental implant is properly anchored to support the stress of biting and chewing food.

– The maxillary sinus is too close to the area of placement. This means that there is not enough bone between the tooth area and the sinus. Usually, this can be fixed by lifting the sinus membrane (Sinus Lift) and placing bone graft material.

– Inadequate bone as a result of previous tooth or teeth removed. Sometimes when teeth are removed or fall out, bone structure can be removed as well. The bone will also decrease and remodel once the tooth is removed as it no longer is needed to hold a tooth in place.

– Not enough bone due to periodontal disease or trauma. Periodontal disease and trauma can lead to there not being enough bone present for a successful dental implant.

– Inadequate bone due to a defect in development that affects the growth of bone in the jaw.

– Insufficient bone caused by the removal of cysts or tumors in the mouth. If the removal of a cyst or tumor is required, there will also be the removal of some of the bone. There may not be enough left for the dental implant to be supported. After the removal of oral pathology, healing time is required so that bone quality and quantity can be reassessed.

Where Does The Bone Come From?

Bone grafting procedures will use your bone, cadaver bone, cow bone, and synthetic bone. Your own bone will most likely come from your chin or ramus (the back part of your lower jaw). If your dentist is unable to get enough bone from either of these areas, they may need to harvest bone from your hip or shin bone (tibia) instead. The hip is considered to be a better source because the hip bone can provide a large amount of bone. The marrow from either the hip or shin (tibia) contains bone-forming cells. Although bone taken from your hip requires a visit to the hospital along with general anesthesia. Cadaver bone and cow bone are sterilized and broken down into small chips for an easy placement. Man made synthetic materials are also commonly used for bone grafting. The synthetic bone acts as a scaffold for new bone to build upon.

Newer products containing growth factors have also been developed. Some can enhance bone graft materials and others are used in place of bone grafting. One of these products, BMP-2, stimulates certain body cells to turn into bone. The BMP-2 protein occurs naturally in the body.

The Bone Grafting Process

A good example is a patient that needs to have a single tooth extracted and wants to have it replaced with a dental implant and dental crown. There may be a bone defect in the area or the tooth is large and needs to have bone placed in order to fill the expansive space. In this case, a dental bone graft is ideal and necessary to support the dental implant.

Before the procedure, you will need to have either a CT scan or a cone-beam computed tomography (CBCT) scan. The images of a CT or CBCT provide valuable information about bone quantity and show where important nerves and sinuses are located, which need to be avoided. A CBCT actually provides a 3-D image of your bone and any defects that are present. Local anesthesia will be used to numb the area where the bone augmentation is needed (called the recipient site) as well as the area from where bone will be removed (donor site) if using your own bone. An incision in the gum tissue where the implant will be placed is made to determine how much and what type of bone is needed.

The most common type of graft is called a socket graft. This graft is used to fill the space left behind by the lost tooth. The material used in a socket graft is often comprised of cow bone. This bone is harvested from known healthy cows and is processed through a freeze drying procedure that renders a sterile end product containing only the mineral content of natural bone. The socket graft is applied to the empty hole immediately after a tooth extraction and is secured using sutures (stitches).

Following the bone grafting procedure, the patient is given antibiotics, pain medicine, and an antibacterial mouthwash. You will need to avoid certain foods during the healing process. You also will be told how to avoid putting pressure on the area or damaging it while it heals. If you wear a denture, you may not be able to wear it for a month or longer while the area heals. If you have natural teeth around the bone graft, your dentist may make a temporary removable bridge or denture to help protect the area.

Advantages Of Bone Grafting

The success rate of bone grafts in the jaws for the purpose of placing dental implants is very high. However, there is a small chance that the bone graft will fail, even using your own bone. Bone grafts are not rejected like organ transplants. It is not exactly known why some dental grafts fail. Although there is a higher risk of failure in patients with diabetes, who smoke, or have periodontal disease. A failed graft can be removed. Once the area has healed, your dentist may choose to place a second bone graft.

Bone Grafts 

Without dental bone grafts, many patients would be unable to restore their smiles with dental implants. Similarly to dental implants, dental bone grafts are highly successful procedures to restore a smile to its natural state. Every case is different and the need for bone grafting varies from person to person and tooth to tooth. You can discuss the need for bone grafting with your dentist to see if it would benefit your dental implants procedure.