Dental Bone Graft Preparation
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After you have reviewed the dental bone graft information, if you have not already done so, take a moment to review some of the ways to get free adult dental clinic care from licensed dental practitioners. Please refer to the link which appears at the end of this article. Bone Graft Procedures A dental bone graft procedure is performed to reverse the bone loss or destruction caused by periodontal disease, trauma, or ill fitting removable dentures. It is used to augment bone for implant placement, enhance the fit and comfort of a removable prosthetic appliance, or enhance esthetics of a missing tooth site in the smile zone. When a person loses a tooth, the surrounding bone collapses. To preserve this bone for a dental implant or for esthetics, bone grafting is used. There are many ways in which a dental bone graft can be performed. It can be as simple as collecting bone from the patient, then reusing the bone for grafting purposes. Whenever a patient’s own bone is used, the best results are usually achieved. In extreme cases, bone can be harvested from areas outside the mouth. The most common area is the hip. While most dentist believe the best material for a dental bone graft is your own bone, your dentist can use materials made from the bone of human cadavers or some other type of synthetic materials. Implant Dental Bone Grafts The success of a dental implant and its ability to support a dental restoration depends upon how much bone is available at the site where the implant will be placed. Periodontal disease, trauma, infections and developmental defects are some things which effect bone volume. It is also not uncommon to open up a site in the mouth for implant placement and find that some of the critical supporting bone missing. If your jaw is too short or too narrow or both, you will need to have a procedure, such as a dental bone graft performed, in order to add bone to your jaw before implants can be inserted. Bone augmentation is used to describe a variety of procedures that are used to "build" bone so that dental implants can be placed. The procedures involved usually include grafting (adding) bone or bonelike materials to the jaw, then waiting for the grafted material to fuse with the existing bone. This process can take several months to occur. Because there are different procedures that can be used for building bone, your dentist will select a procedure depending on the type, location and number of implants to be used. If you need bone augmentation, it is important that you and your dentist discuss all of the options available. After a bone augmentation procedure, the typical waiting period before implants are placed is between 6 and 12 months. Types of Dental Bone Grafts Most bone augmentation procedures involve the use of the following dental bone grafts: autogenous, allografts and xenografts. Unlike Allograft, Allografts and Xenografts both do not require a second surgical site and ample amounts of this type of bone can be easily obtained. Autogenous Grafts Generally considered the best material for dental bone grafts, autogenous bone is the process whereby bone taken from adjacent sites of the patient such as the chin, hip or other areas of the patient’s body when the goal is a dental implant. Autogenous bone is the standard as it oftentimes has the most predictable results. It is considered the best type of dental bone grafting technique because the bone is live bone and contains active cellular elements that enhance bone growth, whereas other types of grafts are devoid of any active cellular material. Allograft Grafts Allografts is synthetic bone or bone derived from genetically unrelated members of the same species, such as cadaver bone. Cadaver bone such as freeze dried cortical bone has been specifically prepared and found to be very effective for dental bone graft procedures. Cadaver bones promote the patients own bone to grow into the repair site, while synthetic materials stimulate bone formation, using factors from the patient’s own blood to accelerate and promote bone formation in the dental graft areas. Xenograft Grafts Xenografts involve the use of bone that is been taken from other species such as cow. These materials generally work by either Osteoconduction or Osteoinduction. Osteoconduction involves the formation of new bone from host cells along a framework of a compatible biological material. Osteoinduction involves the formation of new bone from the biomechanically differentiation of the host mesenchymal cells. Bone Morphogenic Protein (BMP) is the material that stimulates osteoinduction which is rapid growth of bone just about anywhere on the body. While most dentists prefer to use a person's own bone, maybe in combination with other materials, the choice is yours. Discuss your options as well as the risks and benefits with your dentist before deciding to perform a dental bone graft procedure. If you decide to have bone taken from your own body to use for bone grafting, it will most likely be taken from the chin or the back part of your lower jaw area. If your dentist cannot get enough bone from these areas, then the hip or shin bone area may be used instead. The hip is considered to be a better source because the hip area contains a lot of marrow that contains bone-forming cells. |
Example of a Dental Bone Graft ProcedureScenario: A patient has lost a single tooth and wants to have it replaced with a crown supported by a dental implant. However, the tooth has been missing for several years and there is not enough bone structure to support a single tooth implant. Dental Bone Grafting at the Site of Bone Removal Bone is taken from the patient's chin and used to "rebuild" the lost bone in order for an implant to be supported. This type of bone grafting procedure would be done in a dentist's office. Local anesthesia is used to numb the area where the implant will be placed and bone grafting is needed. Anesthesia is also applied to the chin area where the bone will be removed. The dentist begins by making an incision in the gum area where the implant will be placed. This is to determine how much and what type of bone will be needed for dental bone grafting. Once a determination has been made as to the type of bone that is needed for dental bone grafting, the dentist will make an incision in the gum below the lower front teeth to expose the chin bone. A block of bone will be removed from the chin along with any bone marrow. Many dentists will fill the spot where the bone was removed with another type of bone-graft material, and will cover this area with membrane. Membranes are used to stabilize the bone graft, as well as displace gum tissue from invading the healing dental bone graft. When there is a defect in bone, there is a competition between the bone cells and the epithelial and connective tissue cells to fill up the defect. If left alone, bone usually looses. The membrane allows the bone to win by blocking out the epithelial cells and the connective tissue cells from the site, in this case the gum tissue. Gum tissue grows at a much faster rate than bone, therefore, the use of membranes prevent gum tissue from growing in and displacing the dental bone graft before it matures. The process is usually referred to as the Barrier Membrane technique. This technique guides in the generation of new bone. It involves placing special materials over the dental bone graft site to promote the growth and migration of cells into healthy bone. These membranes are very successful and are used quite often to promote good bone formation. The membranes are usually removed later on, but sometimes they can be resorbed by the body and disappear. After the membrane has been inserted, the incision is then stitched closed. The dentist then proceeds to place the removed bone at the site where the implant will be placed. Note: It is not uncommon to use "screws" and "tacks" to secure membranes and dental bone graft at an implant site. Sometimes these items will need to be removed at a later date. These components and grafting materials are safe and effective and has contributed to increasing the success rates of dental implants. Dental Bone Grafting at the Implant Site The dentist the first will drill little holes in the existing bone at the implant site to cause bleeding. The reason for this is to allow the cells in blood to help the bone to heal. The block of bone that was removed from the chin is then anchored in place with titanium screws. A mixture of the patient's bone marrow and some other bone-graft material will then be placed around the edges of the bone block. Finally, the dentist will place a membrane over the area and will stitch this incision closed as well. After the dental bone grafting procedure is complete, antibiotics, pain medication and an antibacterial mouthwash are given to the patient. The patient must avoid certain foods, and be instructed on how to avoid putting pressure on the area while it heals. If dentures were worn before the procedure, they will not be able to be worn for at least a month or longer while the area heals. If natural teeth are near the dental bone graft, the dentist may make a provisional removable bridge or denture to help protect the area. The dental bone graft process will take from 6 to 12 months to heal before dental implants can be placed at the site area. Prior to the implant being placed, the titanium screws used to anchor the bone block in place will be removed. |
Building Up Bone for Several Implants Some people wanting implants may be missing several teeth and need several implants, as well as a dental bone graft. Because more bone graft is needed, the bone will probably need to be taken from the hip, shin or another site. Due to the amount of bone buildup needed in this case, this type of dental bone graft procedure is done in the hospital under general anesthesia, and usually requires an overnight stay at the hospital. Bone Grafting Success Rates The rate of success for dental bone grafts as it relates to performing dental implant surgery is very high. However, there is always a chance that the dental bone graft will fail, even in cases where the person’s own bone was used. The failure of a dental bone graft usually is because of an infection or because the grafted bone was unstable and loosened from the jaw. Dentists don't know with certainty why some bone grafts fail, but they do know that people who smoke and have certain medical conditions possess a higher risk of graft failure than others. If a dental bone graft fails, it is removed and a second graft can be placed once the area has had a chance to heal. Other Types of Implant Dental Bone Grafting Procedures In addition to bone grafting, there are many other types of procedures that can be used to build bone so that implants can be place: The Sinus Lift - The sinus lift increases the height of your upper jaw by filling part of your upper sinus area with bone. This procedure is performed when there is not enough bone to allow implants to be placed in the back part of the upper jaw. The Ridge Expansion - is performed when the jaw is not wide enough to support implants; the height and/or width of the ridge area is increased in order to accommodate a dental implant. Distraction Osteogenesis- refers to the process of separating two pieces of bone in order to form of new bone. The Sinus Lift The human skull has several cavities or air spaces which are called sinuses. Sinuses make the head lighter so that it can be supported on the neck. Sometimes, the sinus cavities are enlarged and intrude on dental implant site areas. To place a dental implant into the sinus would only result in placing it into an air cavity where nothing is holding it in place. So bone or bone growth stimulating material is introduced into the sinus. A sinus lift procedure only affects the maxillary sinuses which are located just over the molar teeth in the upper jaw. There are no sinuses in the lower jaw. To introduce bone into the maxillary sinus, the side of the sinus is opened and the bottom portion of the sinus is raised in order to fill in with bone. After several months, dental implants can be placed into in solid bone. Sometimes, after raising the sinus, dentists may find that there is enough bone to place the implants and can proceed with the dental implant much sooner. There is also a more conservative way to grow bone in the sinus. An "Osteotome Lift" raises the floor of the sinus right over the area of the implant site. This dental graft procedure can be done without actually opening the sinus. The healing and implant integration process will proceed as normal. Sinus lifts of all types have had high success rates and are commonly used to effectively promote dental implant procedures. |
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| Stage 1 Area | Stage 2 Area | Stage 3 Area |
This procedure involves elevating the sinus membrane and placing the bone graft onto the sinus floor (Stage 2 Area). This allows implants to be placed in the back part of the upper jaw when teeth have been removed and bone loss has occurred. The implants can often be placed at the time the grafting is performed (Stage 3 Area)
Ridge Expansion
Another type of bone augmentation procedure is called a ridge expansion. In severe cases the ridge has been reabsorbed and a bone graft is placed to increase the ridge height and/or width. In these situations, the graft is taken from another area inside your mouth. This procedure can be performed in a doctor’s office under local anesthesia and takes about an hour. A ridge expansion is a type of bone graft procedure that is performed when the jaw is not wide enough to support implants. A special saw is used to split the jaw along the top, then dental graft material is packed into the newly created space (Step 5). Some dentists will immediately place implants after this procedure is done (Step 6), while other dentists’ will wait several months for the ridge to heal.
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| Step 1 | Step 2 | Step 3 | Step 4 | Step 5 | Step 6 |
Distraction Osteogenesis One of the newest procedures of bone augmentation is called distraction osteogenesis. The term distraction refers to the process of separating two pieces of bone, while the term osteogenesis refers to the forming of new bone. Originally used for lengthening the bones of patients with abnormally short legs, distraction osteogenesis has been adapted for regeneration of lost bone structures of the face and mouth. The procedure involves a surgeon cutting the jawbone to separate a piece of bone from the rest of the jaw. A titanium device is inserted into the jaw with pins or screws holds the piece of bone apart from the rest of the jawbone Over time (usually over a period of days or weeks), the space between this piece of bone and the jawbone is widened slightly by unscrewing the device, while the area between the pieces gradually fills in with new bone. |
Costs of Dental Bone Grafts There are some potential downsides when dental bone grafting is needed for a dental implant. The process of the bone graft and the healing period may add a significant amount of time to the process. Another downside is the increasing costs associated with dental bone grafting and dental implant procedures. Some dentists attempt to keep the costs of dental implant procedures as low as possible, while other apply very high fees when dental bone grafting is involved. They tend to mystify these procedures and make them appear to be very costly. According to one doctor, a bottle of Freeze Dried bone costs about $95.00, while membranes cost between $35.00 and $150.00. He uses a sliding scale for grafting charges from $250.00 to $750.00 based upon how much bone and other materials are used and the difficultly of the procedure. His fee for a sinus lift is $1250.00, well below that of other dental offices where charges can range from $2500.00 to $25,000.00 depending upon the type of grafts. He believes that some dentists use tactics to inflate the fees for dental bone graft procedures, and wants patients to be informed about the process. He also discussed some dentists utilizing a technique which involves the use of a platelet centrifuge. The process involves withdrawing and placing a small amount of the patient's blood into the centrifuge, which then creates plasma that is rich in platelets. These platelets are then added to the bone graft in order to speed up the healing process. While, the use of a platelet centrifuge is useful in promoting bone graft development, the equipment can cost several thousands of dollars and the costs are passed on to the dental patient. He believes that some dentists tend to overuse the technique to pay for their investment. In one instance, a patient, who had more bone that he could possibly ever need, was given a platelet sediment treatment and charged an additional $2500.00! So if you are looking to get a dental implant, research the process of bone grafting in the event that you will need to have this procedure performed prior to the implant placed. Then research those doctors who perform the procedure and do a shopping comparison. Knowing that there are disparities in the costs associated with a dental implant can save you hundreds, if not thousands of dollars for a dental implant procedure. Also be certain to look at getting implant procedures performed at a dental school. Please review my article on how to receive discounted and low cost dental work at this type of facility. Learn how to get such things as a discounted dental plan, a cheap dental plan, or a low cost dental benefit plan to help you pay for dental care. This information is provided to you as a way to help you take control of ever increasing dental costs. Learn how to get low cost dental implants (or a free dental implant procedure), dental mouth guards, dental bridge work or a dental bone graft at significantly reduced rates. Join the hundreds of other individuals today. Don’t delay – learn the way to achieve affordable family dental care. Enter Here Did you find this page helpful? If you need additional information, use the SiteSearch toolbar below to search the web. Wishing you well with your dental needs, |
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