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 that fulfills a wide variety of functions in the field of periodontics.

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 aesthetically pleasing.

There are several types of dental bone grafts.

The following are the most common:

• Autogenous bone graft – In this type of graft the bone is removed from elsewhere in the body and implanted in the mouth. Common donor sites for bone grafting include the iliac section of the pelvis, the chin, and the posterior third molar areas of the jaw.  If large amounts of bone need to be harvested, the hip or the shin bone (tibia) is generally used.
• Allograft – Synthetic bone (manmade) can be created in the laboratory and used in the bone grafting procedure. Bone can also be obtained from a bone bank (cadaver bone).
• Xenograft – This is the implantation of bovine (cow) bone. A xenograft is perfectly safe and has been used successfully; ample bone can be obtained, and a secondary donor site is not 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.

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 entails elevating the sinus membrane and grafting bone onto the sinus floor so that implants can be securely placed.

Ridge augmentation – Ridges in the bone can occur 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 uniform shape.

Nerve repositioning – If the inferior alveolar nerve requires movement to allow for the placement of implants, a bone grafting procedure may be required.  The inferior alveolar nerve allows feeling and sensation in the lower chin and lip.

What does bone grafting treatment involve?

Bone grafting is a fairly simple procedure that can be performed under local anesthetic; however, if large amounts of bone area need to be grafted, a general anesthetic may be required.

Initially, the grafting material needs to either be harvested or prepared for insertion.  A small incision is made in the gum tissue and then gently separated from the bone.  The bone grafting material is then placed at the affected site.

The bone regeneration process may be aided by:

• Gum/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 occur during natural tooth development. Emdogain is a matrix protein product that is usually placed on the affected site before the gum is sutured.  It mediates the formation of acellular cementum on the tooth which provides a foundation to allow periodontal attachment to occur.  Tissue-stimulating proteins help 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 consultation now at Mina Family Dentistry, One of the best Markham Dental practices!

Bone grafting

The bone grafting procedure is used to restore and regenerate bone in areas where it has been lost or damaged. This process is commonly used for preparing dental implants, particularly when the jawbone doesn’t have enough density or volume to support the implant. Bone grafting involves the transplant of bone tissue, which can be taken from the patient’s own body called autograft, or from a donor called allograft or even synthetic materials. The bone graft serves the purpose of a scaffold, which means it actually helps bone growth, gradually being replaced by the patient’s natural bone after some time.

Types of bone grafts

There are various types of bone grafts available each suited for a different need. Autografts involve using bone from the patient’s own body, usually from areas like the hip or another part of the jaw. This type of bone graft is highly effective because the bone is compatible with the patient considering the genetic compatibility. Allografts are bone types that are sourced from bone banks. The bone is sterilized and treated to ensure its safety. Lastly Xenografts are also available which is a bone from an animal source, using these types of grafts is rare as they may include pathogens.

Techniques and procedures

Bone grafting involves several techniques each suited to specific dental needs.

Socket preservation:

Socket preservation is a common procedure performed after a tooth extraction to prevent bone loss in the area where the tooth is removed. By placing the graft into the empty socket, bone is preserved, allowing for a stable foundation for dental implants in the future. This technique is important in aesthetic zones where the natural contour of the jaw is critical.

Ridge augmentation:

Ridge augmentation is an advanced bone grafting technique aimed at increasing the width or height of the alveolar ridge, which may be compromised due to various factors, such as trauma disease or tooth loss. The procedure involves various actions such as placing a bone graft on the ridge, which integrates with the existing bone, enhancing the appearance and integrity of the jaw. Ridge augmentation is often needed for dental implants where the required bone structure is insufficient.

Sinus lift:

Sinus lift is a specialized bone grafting process used to increase bone volume in the upper jaw, in molars and premolars. This technique is necessary when there is not enough bone in the upper jaw, or the sinuses are too close to the jaw for dental implants to be securely placed. The sinus membrane is lifted and the bone graft material is placed in its newly created space. Allowing the growth of new bone. This process improves the chances of successful dental implants in areas with limited bone.

Guided bone regeneration (GBR):

The guided bone regeneration technique uses a barrier to direct bone growth in areas where there is not enough bone for implants. By using these advanced techniques, mina family dentistry can provide comprehensive care that meets the needs of every patient.

Gum and bone tissue regeneration

Gum and bone regeneration are critical aspects of restorative dentistry, in the treatment of periodontal disease and preparation of dental implants. Gum disease causes damage to the soft tissue (gums) and the hard tissue (bone). Regeneration techniques aim to restore and address these issues. Using advanced techniques such as bone grafting and guided tissue regeneration, dentists can rebuild the lost structures, improving oral health and enhancing the appearance of the smile.

FAQ

What is bone grafting and why might I need it?

Bone grafting is a process to restore and regenerate bone in the area where it has been lost or damaged. It is commonly used for dental implants, especially if the jawbone doesn’t have enough bone volume to support the implant.

What are the different types of grafts available?

There are 3 different main types of grafts available, autograft, allograft, and xenograft.

What are the main reasons for needing a bone graft?

There 4 different reasons for needing a bone graft, dental implants, sinus lift or ridge augmentation, and nerve repositioning.

What does the bone grafting procedure involve?

The bone grafting process involves harvesting the graft material, making an incision in the gum tissue and placing the graft, and lastly suturing the gum and scheduling a follow-up appointment with your doctor to assess the progress.

How does bone grafting aid in dental implant placement?

Bone grafting thickens and strengthens the implant site by adding bone tissue to where it’s needed. This creates a great base for dental implants, ensuring they are attached to the jawbone securely.