Gum and Bone Grafting

A dental bone graft uses external bone material to add structure to your jaw where bone loss has occurred. Once the bone graft has been placed, it holds space for your own body to do the repair work.

The bone graft material may be taken from your own body (autogenous) or purchased from a human tissue bank (allograft) or an animal tissue bank (xenograft). In some cases, the bone graft material may be synthetic (alloplast).

In some cases, your dental provider may combine a dental bone graft with platelet-rich plasma (PRP), taken from a sample of your own blood and is used to promote healing and tissue regeneration.

Why You Might Need a Bone Graft

Dental bone grafts are often used when bone loss occurs in your jaw. Some cases of when you may need a bone graft includes:

• tooth extractions
• dental implants
• rebuilding your jaw for dentures
• bone loss due to gum disease

How common are dental bone grafts?

Dental bone grafts are very common. They are often done to prepare for other common procedures such as tooth extractions, dental implants, or dentures. This service can be performed by a general dentist or by a specialist, such as a periodontist or an oral surgeon.

Types of Bone Grafts

There are four main types of bone grafts:

• Socket Preservation: Also known as ridge preservation, a type of bone bone graft used immediately after a tooth extraction. This graft prevents the sides from caving in by filling the void left by the extracted tooth.
• Ridge Augmentation: After time, areas of your jaw that are missing teeth may become thin. This type of bone graft increases the width and volume of the jawbone so it can be a stable foundation for implants or other restorative procedures.
• Sinus Lift: The maxillary sinuses sit above your upper back teeth. If the back teeth are missing, these sinuses can drop down into the space where there was once teeth roots. This situation will stop any kind of dental implant procedure. In this procedure, the sinuses are lifted and a bone graft is inserted where teeth roots once were and creates a foundation for dental implants.
• Periodontal Bone Graft: Gum disease can infect and erode the bone that supports teeth, which in turn loosens teeth. A Periodontal bone graft can be place around a loose tooth to restrict movement and provide additional support.

In most cases, bone grafts for dental implants must heal completely before the implant is put in. Because each patient is unique, recovery times will vary between patients. In rare cases, it may be possible to place a bone graft and dental implant in the same appointment. However, this is decided on a case-by-case basis.

The Procedure

Before a Dental Bone Graft

An oral examination must be completed first. This oral exam will check the health of your teeth, gums and jaw. X-rays will be used to determine the extent of bone loss in your mouth. Your dentist will then discuss your treatment options with you to create your own personalized treatment plan for your specific needs.

During Dental Bone Graft Surgery

The first step is to apply a local anesthetic. Then a small incision is made in your gums. This is to move your gum tissue so your jawbone is exposed. Once the jawbone is visible, the area is cleaned and disinfected and the bone grafting material is added. Finally, the gum tissue is replaced and sewn closed to heal.

After a Dental Bone Graft

There may be pain, swelling, and bruising after bone grafting surgery. These side effects are normal and should go away after a few days. These symptoms can be managed with pain relief treatments, and in rare cases, can be prescribed antibiotics by your dentist also. Please follow your prescription instructions exactly.

It is possible that small bone fragments may be removed from the over the next few days after your surgery. These fragments will resemble small grains of salt or sand. Normally these bone fragments are not cause for concern, but you may call your dentist to check that you're healing as expected.

Is the Procedure Painful?

In most cases, there is little to no pain due to bone grafting surgery. You only need to make sure you are taking all medications are prescribed and to follow your post-operation instructions closely.

Are You Put to Sleep?

Bone grafting procedures do not usually reuire being put to sleep and can be done with only local anesthesia. Many dental providers can offer sedation for your comfort and should be discussed before the operation. In some cases, if the procedure is more involved, general anesthesia may be recommended. These options should be discussed with your dentist before the operation.

Possibility of Failure?

Dental bone grafts have very high success rates. However, like any procedure there is always a possibility for failure. Especially among patients who smoke or have specific medical conditions. Signs of dental bone graft include:

• Pain or swelling worsens after the first week post-operation
• Pus or drainage discharge from the bone graft site
• Gums recede
• No improvement in jawbone structure

Risks and Benefits

Advantages

Dental bone grafts help increase your eligibility for dental implants and other restorative dentistry procedures. This procedure is also helpful in restoring your jaw to its original form after bone loss.

Risks

In general, oral bone grafts are safe. However, the procedure does have its own risks present, which includes:

• Infection
• Heavy bleeding
• Nerve damage
• Complications from anesthesia

Recovery and Outlook

How Long is Recovery?

You may feel back to normal after one or two weeks, for a bone grafting procedure to completely heal could take anywhere between three to nine months, and in some cases longer than that. Recovery time for a bone graft depends on several factors, including the type of graft, the area where the graft was placed, and your body's healing capabilities.

When Can I Return to Work or School?

In most cases, patients can return to work or school the day after the procedure. If you chose to have sedation done for the procedure, you may need to take a few extra days to recover at home.

What Are the Healing Stages of Bone Grafting?

As already mentioned, recovery times vary for each unique patient. When the bone graft is placed, your dentist will monitor your healing. If you are waiting to undergo implant surgery, your dentist will let you know when the graft is strong enough to support the implant.

When to Call a Doctor

After a dental bone graft has been placed, keep an eye out for problematic symptoms such as:

• Severe pain
• Increased swelling
• Pus around grafting site
• Fever of 38°C or higher

If any of these symptoms are present, call your dentist immediately.