It is not unusual for a patient to present for a consultation and be informed at some point in the discussion that he or she may require a “bone graft” in order to maximize the outcome of dental implant surgery. While this sounds pretty scary at first, the truth is that bone grafting or “bone regeneration” is a routine, predictable and painless procedure.
Bone regeneration came about to allow for dental implant placement and preserve our appearance. The fact is that as we age and lose teeth, the underlying jaw bone that supported the teeth “atrophies” or is lost with disuse. This will affect our ability to eat and our appearance as the jaw bone provides cheek and lip support so they do not sink in. The truth is that the only reason our jaws have the amount of bone that they do is because of the presence of existing teeth and the fact that those teeth are under continuous function.
Bone regeneration of earlier years involved harvesting and using large quantities of the patient’s own bone. Today we use processed bone that has been sterilized and has had all organic material removed. This is commonplace in most surgical offices today and is a tried and proven technique for many years now.
A simplified explanation for the success of this form of grafting is that this regenerative material is placed as building blocks for your body’s own cells. Initially, it mechanically prevents the collapse of the surrounding tissues, whether that being bone or soft tissue. Then, through a process called “guided tissue regeneration”, the human body is fooled, biochemically, to recognize the graft as natural bone and uses it to grow and replace with its own bone. So the bone in the end is yours!
As discussed in the prior section on the “history of bone grafting,” the simple extraction of a tooth leaves in its wake a hole that is surrounded by a shell of bone. This bone’s only purpose in the human body is to support a tooth. As a result, when the tooth is lost the body quickly begins to resorb the bone, unless it is immediately replaced with either an implant or in this case a “preservation graft”. Frequently, it is possible to place an implant at the time of a tooth extraction. In these cases, the implant will act almost like a tent pole to hold the surrounding bone up and give it the functional requirements necessary to prevent it from undergoing atrophy. Unfortunately, sometimes it is impossible to place an implant at the time of the extraction. This can be for many reasons. However, it is most frequently due to either the presence of a dental infection or a size discrepancy between the tooth that is being lost and the size of the replacing implant.
In these cases most often molar teeth, bone regeneration will be necessary. The graft will fill the void left by the extracted tooth and hold the volume of this space while natural bone has the opportunity to proliferate and fill the space with your high quality live bone. Depending on the size of the tooth that was extracted, the graft requires between three to six months before an implant can be placed.
The maxilla or upper jaw has several qualities that make it unique to grafting as well as the placement of implants. The most significant difference in the maxilla when compared to the mandible lies in the presence of the maxillary sinus. The maxillary sinus is one of the several natural air spaces that are anatomically present in all human skulls and it can impose itself on the roots of the teeth in the upper jaw.
As a consequence of this relationship, when a tooth is lost, the result may be the presence of very little bone between the oral cavity and this air space. In turn, this can make the placement of an implant in the posterior of the upper jaw a slightly bigger project when in comparison to other areas of the jaw. Fortunately, a relatively simple solution has been developed to handle this problem and render a safe, effective and stable result for placing implants. Regenerating bone in the sinus has been performed now for many years to allow implants to be used as a replacement for upper molars. The patient should not fear that this will have an adverse effect on their sinuses. Our experience with this procedure is not only vast and longstanding; its use has been commonplace for many years with no side effects.
The success of a dental implant and its ability to support your new teeth is very much dependent upon how much bone is available in the site where your implant is placed. Dr. Pottorff will know when additional bone or bone repair will be necessary before actually starting the placement of your dental implant. There are many benefits of bone grafting for patients who are candidates. To learn more, read our FAQs.