Know All About Bone Graft

CONTENTS

What Is The Treatment For Bone Loss In Teeth?

In conditions that cause the loss of a tooth, the bone beneath also gets affected. If the width and the height of the bone don’t suffice a new implant, a bone graft will have to be put in. Some conditions that can affect the bone beneath include:

Periodontal disease; infection and inflammation of the gums 
Dental cavities
Long term denture usage
Trauma
Infection
Defective development of the tooth


What Is A Bone Graft?

Bone grafting is a minor surgical procedure conducted in a dental office. It is used to build up bone that will eventually hold new teeth. 

Procedures like dental implants are common. To provide optimum results, dentists often recommend bone grafting to provide favorable outcomes for the implants. A bone graft helps to support a dental implant and eventually a tooth, which is placed on the implant. Bone grafts are painless and routine procedures. 

A Bone graft is also called an Autograft and an Allograft.


Who Are The Ideal Candidates For Bone Graft?

Bone grafts can be placed in most adults who eventually undergo a dental implantation procedure.

Bone surrounding the missing tooth should be of good density. This will help the healing process of the grafted bone.

Autoimmune disorders like diabetes can impair healing. A patient with such conditions would have to consult with a physician who can conduct a pre surgical exam to ensure the procedure can be carried out without much hassles.

Periodontal disease affects the bone underneath the gums. Therefore some patients will have to treat gum that are infected before a grafting procedure can be conducted.


What Are The Different Types Of Bone Graft?

Socket Grafting: The tooth that has been lost due to infection or trauma will leave a cavity in the bone within the gums. The dentist can opt to fill it with some graft material which acts as a base, around which bone cells will migrate and form a layer of new bone cells.

Ridge Augmentation: This kind of procedure is used when there is too much bone loss after a tooth is lost. The dentist uses an allograft in this case to fill the void completely to restore the former structure of the bone. Ridge augmentation price is about $4600 in the US.
 
Sinus Lift Procedure: This technique is commonly used for teeth missing in the upper jaw. An incision is made is the maxillary sinus or the area above the upper jaw. The sinus tissue is moved upward and bone tissue is filled into the cavity created. After the procedure is conducted, a dentist will wait for a few months to allow the jaw to heal and remodel, to eventually support the implant.


What To Do Before A Bone Graft?

  • Teeth need to be brushed and mouth needs to be rinsed prior to the procedure.

  • Smoking has to be stopped at least two weeks prior to the procedure. Nicotine is known to cause constriction of the blood vessels, which eventually slows down recovery. Smoking also hinders the maintenance of good oral hygiene.

  • Blood thinning agents like aspirin and herbal supplements need to be stopped a few weeks prior to the procedure. These prolong the recovery time and cause bleeding in the surgical site.


What Is The Post Operative Care For Bone Graft?

  • Swelling and soreness can be managed with aftercare measures like placing ice packs on the gums after a bone graft.

  • After the surgery, a dentist generally prescribes antibiotics to prevent the development of an infection during the recovery stage.

  • Pain medications can help with the pain, which can be prescribed as per the patient’s requirements.

  • Pateints will have to avoid wearing dentures for a few weeks in the healing stages after surgery. A denture puts pressure on the surgical site and prevents proper recovery.

  • A postoperative follow up appointment is generally scheduled for suture removal, and to check the healing of the surgical site.


What Is The Post-operative Diet For A Bone Graft?

Oral hygiene needs to be maintained strictly after the procedure. Teeth need to be brushed twice daily, followed by regular flossing and rinsing with mouthwash.

Soft and pureed foods are the ideal options for the first few days after the procedure. This is because the gums feel numb after the procedure and chewing is often difficult and painful.

Transitioning to solid foods will take a few days. It is best not to skip any meals after the procedure.


What Are The Realistic Expectations From A Bone Graft Procedure?

  • A bone grafting procedure is typically performed to bring jaw bone to a level suitable for dental implants. In some cases, it may happen that there is not enough bone to encompass an implant. This necessitates a bone graft procedure.
  • The procedure brings back your bone to its previous form after a tooth loss or a gum disease or any other tooth complication.

  • A bone graft procedure is performed by adding bone or bone like material, made in laboratory in order to add volume to the jaw. 

  • Though the success rate for this procedure is high, there are possibilities that the bone graft will fail for certain people. Results are uncertain for people who smoke or have medical conditions that could aggravate the pain.

  • Patients need to be aware that it might take 8-9 months of recovery time for the bone graft to heal and completely fuse with the bone. Only after this process, can a dental implant be placed, which can be a month long procedure.


What Are The Pros And Cons Of Bone Graft?

  • Pros

  • Cons

  • For patients who do not have sufficient bone to support a dental implant or artificial tooth replacements, a bone grafting procedure is helpful. Dental implants are generally necessary for aesthetic reasons, or to support dentures and crowns. 

  • Bone grafts can improve the size and shape of bone and gums at the graft site and make your smile aesthetically more appealing.

  • A bone graft can be used to maintain the bone structure after a tooth extraction process.

  • Bone grafting benefits the patient by restoring the balance of his/her face.

  • As in the case of any medical surgery, bone graft too poses a risk of infection. Infections are reported in less than 1% of the cases and can be cured by antibiotics prescribed by the surgeon. Choosing a highly skilled surgeon is essential to rule out the chances for any infection.

  • If the bone to be grafted is taken from the hip, you might find it uncomfortable to walk for a few weeks.

  • Swelling in the grafted area may cause discomfort for up to two weeks. Your surgeon may prescribe you medicines to ease out this discomfort or you can use ice packs.

  • In case of an allograft, bone from a donor may take longer time to fuse, resulting in a longer recovery period.

 


Who Should Avoid Undergoing A Bone Graft?

  • People who smoke excessively should not undergo this procedure as the chances of failure are high due to delayed recovery and graft rejection.

  • Anyone having an untreated periodontal disease should not undergo this procedure to avoid complications like aggravated gum infection. Having an untreated dental disease may also drastically reduce the chances of success.

  • Patients having uncontrolled chronic disorders such as diabetes or heart diseases should not undergo this procedure or carefully discuss the possible outcomes of the procedure with the doctor. 


What Are The Alternatives To A Bone Graft?

In addition to grafting bones, other procedures can be used to build bone to place implants.

Ridge Expansion

This is done when the jaw is not wide enough to support the implants. A saw is used to slit the jaw open and graft material is used to fill this space. This split ridge technique, also supports implants after several months of healing.

Distraction Osteogenesis 

This procedure is done to increase the height of the lost bone within the jaw. A piece of bone is separated from the rest of the jaw and a piece of titanium is placed between the two sets of bone, the one sawed away and the one present within the jaw. Every day, the gap between the bone is increased, until the required amount of space is achieved. This gap eventually fills in with bone material formed inside the body.


Does Bone Graft Lead To Scarring? 

Any surgical procedure that disrupts the natural tissue has the potential to form scars. Bone grafts are almost always successful procedures at the hands of trained dentists. They rarely cause scars. In some instances, however; fibrous tissue forms over the graft instead of bone tissue. This is weaker than the bone and doesn’t favour proper placement of the implant. In such cases, another incision is made and fibrous tissue is removed. This is allowed to heal for a few months, before another graft is placed.


What Are The Temporary Side Effects Of Bone Grafts?

  • Although the procedure in itself is painless as it is performed after the administration of anesthesia, the patient may experience pain after the surgery when the effects of anesthesia fade away.

  • There are chances that the patient may witness swelling and pain at the surgical site. These complications can be taken care of, by taking painkillers and analgesics prescribed by the doctor.

  • Infection can occur at the site of the implant, though the risk is very low. Taking antibiotics prescribed by the doctor beforehand can prevent the chances of infection.

  • The patient might suffer from some general discomfort such as numbness and a tingling sensation, which is likely to go away as the healing process begins.


How To Choose A Surgeon For A Bone Graft Procedure?

Once you decide to undergo a dental bone graft procedure, you should give utmost importance to choosing the right surgeon for your procedure. Choosing an accredited medical facility for your treatment is the best way you can ensure the quality of your surgeon. This is because facilities accredited by internationally acclaimed organisations like JCI maintain high standards of medical practice and have a highly qualified staff.

As with any other surgical procedure, certain risks are associated with bone grafts. There is a possibility of infection if the surgery is not entrusted to a well qualified surgeon.

The bone which is to be grafted can be man made or extracted from your own body or a donor’s body. A skilled surgeon should be able to rightly advise you on the source of the bone to be grafted as it is a crucial decision to make.

In case of an autograft, which involves extracting the bone from the patient's’ own body, an unskilled surgeon may keep the patient under anesthesia for a longer duration than required, which may create problems. 
In case of an allograft, in which the bone is taken from a deceased donor, there are chances of transmission of diseases from the donor to the patient. Keeping all these risks in mind, the patient should carefully choose a well qualified and experienced surgeon. The doctor should have a working licence and a certification from a recognised medical board. Do not hesitate to ask your doctor questions on his medical experience, the techniques he will use for the surgery and success rate of the surgeries performed so far by him. For your satisfaction, you can also ask for testimonials of his patients.

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