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Bone Grafting

Over a period of time, the jawbone associated with missing teeth atrophies or shrinks. This often leaves a situation in which there is not enough quantity of bone suitable for placement of dental implants. In these instances, most patients can become good candidates for placement of dental implants with bone grafting procedures.

Today, oral surgeons have the knowledge and ability to replace and grow bone where needed. Bone grafting not only allows dental implants to be placed where there was once insufficient bone, but it also restores functionality and esthetic appearance by replacing missing bone structure.

Bone grafting can repair future implant sites with inadequate bone structure due to previous extractions, gum disease or injury. The bone can either obtained from a tissue bank (donor bone) or your own bone is taken from the jaw, hip or tibia (below the knee) and relocated. Sinus bone grafts are also performed to replace bone in the back upper jaw area.

Sinus Lift Procedure

The maxillary sinuses are behind your cheeks and above the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up to the bottom of the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the bone between the sinus and the upper jaw ridge is very thin, it is impossible to place dental implants in the back of the upper jaw without adding bone to the sinus (sinus lift procedure).

For a brief narrated overview of the bone grafting process, please click the image above. It will launch an educational Flash MiniModule in a separate window.

During a sinus lift procedure, an oral surgeon enters the sinus from inside the mouth where the upper teeth used to be. The sinus membrane is then lifted upward and bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After six to nine months of healing, the bone graft becomes a natural part of the patient’s upper jaw and dental implants can be inserted and stabilized in this new bone. Sometimes, in certain select cases, the sinus lift procedure and dental implant placement can be completed at the same time. This eliminates the need for an additional surgery. Where as years ago there was no option other than wearing loose dentures, the sinus lift procedure makes it possible for many patients to have dental implants who otherwise could not have in the past.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, a sinus graft and the implant placement can sometimes be performed as a single procedure. If there is not enough bone available, the sinus augmentation (graft) will have to be performed first, then the graft will have to heal for several months, depending upon the type of graft material used. Once the graft has healed, the implants can be placed.

Ridge Expansion

In severe cases where the ridge of the jaw has atrophied or shrunk, a bone graft is placed to increase the ridge height and/or width. This technique restores lost bone dimension when the ridge of the jaw is too thin to place a dental implant. In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. The bone graft is placed and allowed to heal for three to four months before placing the dental implants.

In some cases, bone substitute material is used to augment bone grafting for dental implants. This bone substitute is prepared from human or bovine sources and helps the patient’s own bone heal and grow were needed. It is both very effective and very safe. Sometimes, factors from a patient’s own blood (platelet rich plasma) is used to accelerate and promote bone formation in areas that have received bone grafts.

A majority of bone grafting surgeries are performed in the office surgical suite under IV sedation or general anesthesia, and patients are discharged home that same day. Bed rest or minimal activity is recommended for one or two days afterward.

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