Bone Grafting

Bone grafting is often needed in preparation for dental implant placement. When dental implants are inserted into your jaw, they need to be surrounded with several millimeters of strong, healthy bone. The bone is essential, so the dental implant can bond or fuse with the bone in a process called osseointegration. Good osseointegration ensures the implant is held firmly in the jaw and has enough strength to support a replacement tooth that could be a crown, bridge, or implant denture.

If you don’t have enough bone to place dental implants successfully, you will need dental bone graft surgery. Sometimes, bone grafting is carried out as part of a periodontal treatment plan. Our dentist would place a bone graft to help restore bone around teeth, increasing the chances of saving teeth affected by severe gum disease.

There are several types of bone grafts available:

• Autograft – a bone graft surgery that uses your own bone taken from another site in your body, often the jaw or hip bone. Because the bone is your own, the risk of rejection is eliminated, but you will require another surgical procedure to harvest the bone. Another advantage of using a graft from your own body is that it is living bone, which helps enhance the process of bone regrowth.
• Allograft – a bone graft taken from a human donor. The bone is thoroughly sterilized and extensively processed by being chemically treated, freeze-dried, or irradiated to ensure it is safe to use. Once in place, the dental bone graft provides a scaffold encouraging your body to produce new bone growth.
• Xenograft – a bone graft taken from an animal donor, and is usually bovine. The bone is thoroughly sterilized and processed at a very high temperature and undergoes extensive testing to make sure it is safe. Just like an allograft, a xenograft provides a scaffold helping your body to produce new bone growth.
• Alloplast – a bone graft using a synthetic medium that may contain hydroxyapatite, calcium, and phosphorus. It can also contain proteins and growth factors and collagen. The combination of substances helps to promote new bone growth and faster healing. Synthetic bone is extremely effective and is widely used.

When you visit Gentle Dental, we can discuss all possible options for bone grafting procedure with you and will provide you with detailed information so you can make an informed choice. During your appointment, we will also discuss the type of bone graft surgery needed.

There are several types of bone grafts which are:

• Socket preservation
• Ridge augmentation
• Sinus augmentation

When a tooth needs removing, the bony socket around it is often eroded because of severe gum disease. The process of removing a tooth can also damage the socket slightly, although we are extremely careful to minimize this damage using special techniques when extracting teeth.

When removing a tooth, we will often use a socket preservation technique, where we fill the empty socket with suitable bone graft material. Usually, an artificial membrane is placed over the bone graft and which is a special kind of mesh filter. It can contain growth factor proteins that help stimulate bone growth, and it also prevents the gum tissue from growing into an area where it isn’t needed.

Socket preservation is useful in preserving the bone and gum tissue and can help enhance the final appearance of your dental implant. The additional bone provides a strong foundation for the dental implant. Sometimes socket preservation is used at the same time as placing the dental implant, so your tooth may be removed, additional bone grafting material inserted, and the implant placed during the same appointment.

Natural teeth are supported in what’s called the alveolar ridge, which is a ridge of bone that surrounds the tooth sockets, helping to protect them. The alveolar ridge also provides essential support for your facial muscles.

When a tooth is extracted, the alveolar bone around the socket can begin to break down and resorb. The alveolar ridge gradually loses width and height, which can significantly affect aesthetics and may make it impossible to place dental implants successfully. A ridge augmentation restores missing height and width.

With ridge augmentation, a small incision is made into the gums to expose the underlying bone. The donor bone is carefully shaped to fit the area and is firmly secured in place. Once the bone graft is in position, the gum is stitched over the graft and is left to heal. Sometimes a splint is needed to support the bone during healing, but often this isn’t necessary.

Ridge augmentation restores missing bone, creating the correct contours in your jaw and providing proper support for your gums and facial muscles. When the alveolar ridge is the correct height and width, it provides the proper support for your facial muscles. Also, it ensures your dental implants can be placed correctly, providing the very best aesthetics so that your gums look naturally healthy. When dental implants are placed accurately, it helps to ensure excellent functionality.

You may need a sinus augmentation or sinus lift when replacing upper back teeth. Either side of your nose and just above your upper jaw are the maxillary sinuses and which are air-filled cavities. The jawbone in this area tends to be naturally thinner, and sometimes tooth roots will even extend up into the maxillary sinuses. A thin wall of bone isn’t strong enough to support dental implants, which is why a bone graft is necessary to build up and strengthen the bone.

• During a sinus augmentation, a small incision is made in your gums to expose the jawbone just underneath your sinuses.
• Next, a tiny opening is made in the bone so we can see the membrane that lies between your sinuses and jawbone.
• We gently push or lift the membrane upward, which creates a space between your jawbone and the membrane that we pack with bone grafting material.
• Once the bone graft material is inserted, we will stitch your gums, and the area will begin to heal.

After surgery, you will need to rest for the remainder of the day. It’s normal to experience some swelling the day afterward, but using ice packs during the first 48 hours can minimize this swelling. You may experience some jaw stiffness, which again is a normal reaction to surgery.

Make sure you drink lots of fluids after surgery but do not use a straw as the sucking action could dislodge the bone graft. It’s better to avoid hot foods and to stick to eating cold foods that can soothe the surgery site. Good food choices include yogurt, Jell-O, applesauce, and milkshakes. It’s better to avoid very crunchy foods until your gums have healed.

Many people have a bone grafting procedure before dental implant placement, and it is a routine surgery. If you have any concerns about bone grafting before or after surgery, please contact our dental office at
(718) 461-0100 so we can answer your questions fully.