Bone Grafting from Belmont Dental Group
Periodontal disease is the leading cause of bone loss in the oral cavity,
though there are others such as ill-fitting dentures and facial trauma.
The bone grafting procedure is an excellent way to replace lost bone tissue
and encourage natural bone growth. Bone grafting is a versatile and predictable
procedure which fulfills a wide variety of functions.
A bone graft may be required to create a stable base for dental implant
placement, to halt the progression of gum disease or to make the smile
appear more aesthetically pleasing.
There are several types of dental bone grafts. The following are the most common:
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Autogenous bone graft – In this type of graft the bone is removed from elsewhere in the
body and implanted in the mouth. Common donor sites for bone grafting
include the iliac section of the pelvis, the chin and the posterior third
molar areas of the jaw. If large amounts of bone need to be harvested,
the hip or the shin bone (tibia) is generally used.
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Allograft – Synthetic bone (man made) can be created in the laboratory and
used in the bone grafting procedure. Bone can also be obtained from a
bone bank (cadaver bone).
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Xenograft – This is the implantation of bovine (cow) bone. A xenograft is
perfectly safe and has been used successfully for many years. Ample bone
can be obtained and no secondary donor site is necessary.
Reasons for bone grafting
There are a wide variety of reasons why bone grafting may be the best option
for restoring the jaw bone.
Dental implants – Implants are the preferred replacement method for missing teeth
because they restore full functionality to the mouth; however, implants
need to be firmly anchored to the jawbone to be effective. If the jawbone
lacks the necessary quality or quantity of bone, bone grafting can strengthen
and thicken the implant site.
Sinus lift – A sinus lift entails elevating the sinus membrane and grafting
bone onto the sinus floor so that implants can be securely placed.
Ridge augmentation – Ridges in the bone can occur due to trauma, injury, birth defects
or severe periodontal disease. The bone graft is used to fill in the ridge
and make the jawbone a uniform shape.
Nerve repositioning - If the inferior alveolar nerve requires movement to allow for the placement
of implants, a bone grafting procedure may be required. The inferior alveolar
nerve allows feeling and sensation in the lower chin and lip.
What does bone grafting treatment involve?
Bone grafting is a fairly simple procedure which may be performed under
local anesthetic; however if large amounts of bone area need to be grafted,
general anesthetic may be required.
Initially, the grafting material needs to either be harvested or prepared
for insertion. A small incision is made in the gum tissue and then gently
separated from the bone. The bone grafting material is then placed at
the affected site.
The bone regeneration process may be aided by:
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Gum/bone tissue regeneration – A thin barrier (membrane) is placed below the gum line over the
grafting material. This barrier creates enough space for healthy tissue
to grow and separates the faster growing gum tissue from the slower growing
fibers. This means that bone cells can migrate to the protected area and
grow naturally.
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Tissue stimulating proteins – Enamel matrix proteins occur during natural tooth development.
Emdogain is a matrix protein product which is usually placed on the affected
site before the gum is sutured. It mediates the formation of accellular
cementum on the tooth which provides a foundation to allow periodontal
attachment to occur. Tissue stimulating proteins help to create lost support
in areas affected by periodontal defects.
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Platelet-rich growth factors –A high platelet concentration liquid can be used to create a blood
clot at the site of a wound. It has recently been discovered that PRGF
also stimulates bone growth – meaning a denser graft in a shorter
time period.
The gum is sutured in place and a follow up appointment will need to be
made within 10 days to assess progress. Bone grafting is a highly successful
treatment and a good base for further periodontal restorations.
If you have any questions about bone grafting, please ask your dentist.