Dental Implants and Bone Grafting: Enhancing Jawbone Health for Successful Implant Placement

Did you know that over 3 million people in the US have dental implants to replace a missing tooth or teeth?

The main criterion for dental implant eligibility is having a plentiful supply of dense bone in the jaw. But what happens if a patient's jawbone has deteriorated or there is insufficient volume to support a dental implant? This post explores the role of bone grafting in dental implant dentistry and how it contributes to the long-term success of dental implant placement.

What is bone grafting for dental implant placement?

Bone loss occurs in the jaw for several reasons, with the most common being natural resorption following tooth loss. Infections are another cause of bone loss due to periodontal disease or tooth decay.

Bone grafting is a surgical procedure that aims to reconstruct lost bone to allow for dental implant placement.

The importance of adequate jawbone volume

You probably know that a dental implant is placed into the jawbone at the site of a missing tooth and topped with a dental crown that looks and feels like a natural tooth. The titanium implant post acts as an artificial tooth root to secure the replacement tooth and stimulate the jawbone. It achieves this by fusing with the surrounding bone in osseointegration.

An implant's success largely depends on the foundation of bone to support it. A firm base is necessary to anchor the implant and prevent it from moving.

If the bone in your jaw is not sufficiently broad or deep, it may be necessary to undergo bone grafting before the implants can be placed. Chewing exerts a lot of pressure on the jaw. As such, implants replacing missing teeth need to be large enough to withstand the biting force, and there needs to be sufficient bone to support the size of the implant. If an implant is placed into an area with insufficient bone, it risks becoming loose and falling out. 

A 3D x-ray is taken to analyze a patient's bone structure to determine if a bone graft should be considered before placing a dental implant.

How does a dental bone graft work?

Dental bone grafting increases the bone volume in the alveolar area of the jaw (the bony ridge where the tooth sockets are located). During the process, the dentist will use one of several techniques to regenerate and achieve sufficient bone density to place a dental implant.

There are various techniques to prepare a patient's mouth for a dental implant. These include:

Post-extraction bone grafting refers to when a patient needs a tooth extraction for whatever reason. It involves the surgeon or dentist filling the empty socket to prevent bone resorption, ensuring it can be used later for an implant.  

Pre-implant bone grafting involves increasing the bone's height or thickness in the jaw. The graft comes from various sources.

Sinus lift - This graft is only used for patients receiving an implant in the upper jaw to replace a molar or premolar. A small hole is drilled into the bone to access the sinus membrane and elevate it to prevent the implant from accidentally puncturing it. The bone in the space below is then filled, and the gums are closed.

What materials are used for dental bone grafting?

Various materials are sourced for dental bone grafting. These include:

Autogenous – This is bone taken directly from the patient. For minor bone fillings, the bone is taken from the chin or wisdom tooth area. For larger fillings, it's taken from the hip, tibia, or even the skull.

Allogenic – This material is sourced from specialized laboratories for safety reasons and from a donor patient.

Xenogenic - refers to bone from another species - typically of bovine, porcine or equine origin. 

Alloplastic – This synthetic material is made from a mixture of calcium and phosphate.

What's the procedure for a dental bone graft?

A bone graft procedure starts with a local anesthetic to numb the area of the mouth. Patients may also opt for conscious sedation to make them more comfortable. The following steps occur:

• A small incision is made in the gums
• The gum tissue is moved back slightly to reveal the jawbone
• The area is cleaned and disinfected
• Bone grafting material is added to the defective area
• Sometimes, the graft is covered with a membrane for further protection
• The gum tissue is placed back, and the incision is closed

Post-surgery - What to expect

Following surgery, patients may experience slight pain, bruising and bleeding. These symptoms can be relieved with over-the-counter painkillers and should subside in a few days. You may also be prescribed antibiotics to keep infection at bay.

Patients must follow the aftercare instructions given to them before they leave the practice, and please bear in mind that oral hygiene is of the utmost importance to prevent infection in the graft.

How long does it take to regenerate bone?

It may take several months for the body to accept the grafted material and create new strong bone. It can vary between 2 and 9 months, depending on the complexity of the case and the technique used.

If the bone graft required is small, the dentist may perform the graft and place the implants simultaneously. However, they must be sure there is sufficient bone available to place the implants and then add the graft around them to increase the amount of bone providing support.

All decisions depend on the patient's medical history, a thorough assessment of the bone available, and bone loss, as shown in the x-rays.

The advantages of a dental bone graft

A dental bone graft can increase your eligibility for a dental implant or other restorative treatment by restoring the jaw to its original form following tooth loss, trauma, or periodontal disease.

What are the risks of a dental bone graft?

Generally speaking, dental bone grafts are safe. However, risks include:

• Heavy bleeding
• Infection
• Complications from anesthesia
• Nerve damage

Want to know more about dental implants and whether they're right for you?

Why not schedule a free dental implant consultation with the caring, experienced team at Chesterfield Dentistry? We can bring back your smile and improve your quality of life. Call today on 314 936 3621 or use our online booking service.

Photo attribution: image by KamranAydino on Freepik