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Bone Grafting

Denville Maxillofacial Surgery - Bone Grafting - Cheryl L. Moccio DMD

Bone grafting is often necessary prior to placement of dental implants. In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended for the ensuing restoration.

There are several major factors that affect jaw bone volume:

  • Periodontal Disease – Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
  • Tooth Extraction – Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site during the following three years. Loss of bone results in what is called a “bone defect”.
  • Injuries and Infections – Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.

Reasons for bone grafts

Bone grafting is a highly successful procedure in most cases. It is also a preferable alternative to having missing teeth, diseased teeth, or tooth deformities. Bone grafting can increase the height or width of the jawbone and fill in voids and defects in the bone.

There are essentially two basic ways in which bone grafting can positively impact the health and stability of the teeth:

Jaw Stabilization – Bone grafting stabilizes and helps restore the jaw foundation for restorative or implant surgery. Deformities can also be corrected and the restructuring of the bone can provide added support.

Preservation – Bone grafting can be used to limit or prevent bone recession following a tooth extraction, periodontal disease, or other invasive processes.  Inadequate bone may make placing an implant impossible without more extensive and costly grafting procedures.


Bone Graft after Extraction Collapsed 

Diagram shows bone collapse after an extraction and need for extensive grafting..

What Does Bone Grafting Involve?

Initially, Dr. Moccio will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. Dr. Moccio may recommend a panoramic x-ray in order to assess the precise depth and width of the existing bone. A CAT scan may be recommended to determine the bone condition. Based on these results, Dr. Moccio will determine what kind and how much bone is required.

There are several types of bone grafts. 

Autogenous Bone Graft - Harvested from the patient’s own body 

Allograft Bone Graft - Cadaver or synthetic bone is used in this type of graft.

Xenograft - Cow bone is used in this type of graft.

The bone grafting procedure for what is called 'a socket augmentation', is typically done at the time of the removal of the diseased tooth. Bone is placed into the socket along with a barrier membrane. This membrane may be used to cover the new bone and prevents soft tissue invasion and encourages new bone growth. The bone graft will be replaced with the patient's own bone during the healing process that usually takes 4-6 months. At that point, the site is reevaluated for implant placement with a dental CAT scan.

                                                   Bone Grafting Procedure

 

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