So, what exactly is bone grafting? Bone grafting is a procedure that is required when bone loss has occurred in the jawbone. A bone graft is a highly specialised surgical procedure which plays an important role in our ability to place dental implants for patients who have experienced bone loss. In the past, patients who did not have adequate bone height or thickness would have been told they couldn't have dental implants. Thankfully, modern advances in implant dentistry have provided us with successful techniques to restore lost bone, and make it possible to give you the smile you've been dreaming of.
A key factor in the success of a dental implant will be the quality and quantity of bone in the area that the implant is being placed. When teeth are missing or have been extracted without being replaced, unfortunately the bone around them will also begin to be lost, leaving a less than ideal base for a sturdy dental implant. Most people who have implants placed will not require a bone graft, however if there is a distinct lack of bone, our expert implant surgeons are highly trained in these skilful procedures.
Bone loss can be caused by a number of different factors, including:
The most common cause of bone loss is missing teeth, either through tooth loss or extraction. Our jawbone remains healthy, strong, and thick through stimulating activities such as biting and chewing. Unfortunately, if an adult tooth is removed and not replaced, the jawbone will begin to shrink away. It is estimated that within the first year after the removal of a tooth around 25% of the original bone can be lost, this bone loss will only continue to worsen over time. Where teeth are missing, the alveolar bone (the section of bone that secures the teeth in the mouth) no longer receives the stimulation that Is required to maintain and it begins to deteriorate.
Periodontal disease, also known as gum disease, is an ongoing infection of the gums which has damaging effects on the soft tissues of the mouth, and unfortunately also the jawbone which supports our teeth. There are two types of gum disease, gingivitis, and periodontitis, while gingivitis is a much milder form that is easier to get under control, it can still have an effect on bone loss in the mouth. It is really important to maintain excellent oral hygiene in order to preserve the health of your gums, and in turn, your jawbone.
In some cases, wearing dentures can cause bone loss, certain types of dentures are only placed on top of the gums, meaning they do not provide a direct stimulation of the underlying bone. As we have covered before, lack of stimulation of the bone will cause It to deteriorate and shrink away. You may have a fair idea that this is happening as your dentures will most likely begin to feel loose and require relining to improve the fit.
The problem with regards to bridgework is very similar, the section of the bridge that is covering the space for the missing tooth will again provide no direct stimulation of the underlying bone.
In some cases, misalignment of the teeth can create a situation where the teeth are not in direct contact with each other, which, over time can also cause bone loss due to the lack of situation. This can also occur where TMJ issues are present.
Bone loss can also be caused by developmental deformities, which could mean missing portions of teeth or bone.
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At Belmore Dental our specialist practitioners offer a number of different bone grafting techniques including:
Guided Bone Regeneration – This is a procedure that is most often carried out alongside the placement of your implants. Other than a few minutes of extra surgery time, you won't notice anything different during the implant procedure. Your implant surgeon will add a unique material around the implant and any areas within the site that might have small bone deficiencies. This is a very predictable procedure that is used to increase the amount of bone volume that is present and provide a secure, sturdy base for a dental implant.
Socket Preservation – Sometimes also referred to as ridge preservation, this type of graft is placed into the socket immediately following a tooth extraction, filling the void left behind by the extracted tooth and preventing the sides of the socket from caving inwards.
Sinus Lifting – The bones within the face are hollow and contain air spaces that we know as sinuses. The maxillary sinuses sit above the upper back teeth, when a back tooth is lost, the floor of the sinus drops down into the space where the roots of the tooth used to sit. To place an implant, it is sometimes necessary to push the sinus floor to where it was originally, this is done by adding a bone substitute material. This procedure is obviously only necessary in cases where implants are being placed into the area of your upper back teeth and a CT scan has revealed unsuitable bone levels to securely support an implant here. Again, in the hands of skilled practitioners such as ours, this is a safe and predictable procedure.
Block Grafting – This form of bone graft is rarely required, but when it is, it's usually because a lot of bone has been lost from the jaw. The area being treated is rebuilt using a block of bone taken from another area within the patient's mouth. This might sound like a complicated and invasive treatment, however, our dental implant surgeons are experts in this field, and these procedures are all carried out under a local anaesthetic, ensuring you don't feel any pain throughout.
Following a bone graft procedure, you may experience some general, usually very mild, pain, discomfort, swelling and/or bruising. These are all completely normal side effects and would be expected after any surgery within the mouth. Any pain or discomfort should be easily manageable with over the counter pain killers, if required your dentist will also prescribe an antibiotic.
From a structural point of view, the restoration of lost bone will help to avoid the development of other dental issues. Having good levels of high quality bone will allow the facial structure to remain intact, helping to provide support and avoid the prematurely aged look that can come from bone loss.
The main benefit for many, of having a bone graft carried out is the increased eligibility for dental implant treatment. Where a bone graft has been carried out for this purpose, another benefit would be the self-confidence boost that comes with the replacement of teeth using dental implants and the ability to smile and eat without worry.