Your teeth and jawbone have a sort of symbiotic relationship. Your teeth rely on the bone to help hold them in place. And the bone relies on the teeth to keep it from atrophying or wearing away. Getting an implant to replace a lost tooth might not only involve getting a new tooth. It can also involve bone grafting, particularly if there has been a considerable amount of time between the loss of the first tooth and the placement of the implant.
Why You Might Need Bone Grafting
There are a number of reasons why a person might lose a tooth. In some instances, tooth decay might be severe enough that a person loses the tooth or that a dentist is unable to repair the damaged tooth with a simple filling. Gum or periodontal disease can also be so severe that the tooth or teeth fall out and need to be replaced by a dental implant.
In some cases, a patient doesn’t just lose the tooth. Depending on how long it has been between the time of the tooth loss and the time of an implant, the jawbone that previously supported the natural tooth might have atrophied. When the jawbone doesn’t have a tooth to support, it’s common for it to be reabsorbed by the body. The result is that the bone might not be tall or wide enough to support an actual implant. Since the bone is beneath the surface and not seen, many patients don’t realize that they have bone loss until they make an appointment about implants and a dentist takes a look at their teeth.
In those instances, bone grafting can help replace the missing or reabsorbed bone or can help stimulate the growth of new bone.
Bone Grafting Options
There isn’t a one-size-fits-all procedure for bone grafting. Several options are available, depending on the location of the missing tooth and implant replacement and depending on the state of decay and atrophy in the mouth and jaw area.
During a minor bone grafting procedure, the goal is to restore lost bone structure. The area to be treated is numbed and the patient might also be given IV sedation or general anesthesia. The graft will be taken from another area of the patient’s body, from another donor or from a synthetic source. It’s then positioned in the jaw to replace the missing bone and is held in place with screws. During the placement of the graft, the periodontist or oral surgeon also places a special membrane that helps the grafted bone heal and that encourages the growth of new bone tissue.
A procedure known as ridge expansion might be required if a patient has lost a considerable number of teeth and has a considerable amount of atrophy in the jaw. Ridge expansion focuses on widening the jawbone, as it is otherwise too narrow to allow for the placement of implants.
If the dental implant is going to be placed on the upper jaw near a sinus wall, a type of bone grafting procedure known as a sinus lift may be required. During the surgery, the surgeon lifts up the wall of the sinus so that he can position the bone graft into the bottom part of the cavity.
What Material Is Used for the Graft?
The material used for a bone graft can come from a variety of sources. In some instances, it is taken directly from the patient. The surgeon might harvest a small amount of bone from a part of the body, for example. More commonly, the bone might come from another source, such as a human cadaver. The bone graft can also come from another species, such as a cow. In both cases, the harvested bone is dead and, particularly in the case of bone from a different species, has been specially treated to eliminate the risk of rejection.
It’s also possible for the bone graft to be made from a synthetic material, known as demineralized bone matrix, which is made from proteins, collagen and growth factors that come from bone.
What Happens After Bone Grafting?
What happens after bone grafting depends on the type of procedure a patient had and the type of material the dentist used. It’s often recommended that a patient wait several months before having the implants placed. The waiting period gives the bone graft time to fuse with the rest of the jawbone and time to mature.
In terms of recovery, many patients take it easy for the first day or so after the grafting surgery, then return to school or work the next day. It’s usually recommended that a person limit physical activity for about a week or so to give the area time to fully heal. Swelling and some discomfort are common during the first few days after a bone grafting procedure. How much swelling and pain a patient has depends in large part on the extent and complexity of his or her bone grafting surgery.
Dr. John Paul Gallardo and Dr. William Lamas, periodontists based in Miami, FL, and Dr. Juan C. Arroyo, an oral surgeon at their practice, offer a variety of different bone grafting procedures. If you are considering implants and think you might also need bone grafting, call 305-547-8687 to schedule a consultation with the surgeons today.