Bone Grafting
Learn About Bone Grafting in Kingston
What is a bone graft?
Bone grafts are used to fortify areas where the natural bone is compromised or incapable structurally to support a dental restoration. Common causes of structurally compromised bone include periodontal disease or loss of teeth.
If our oral and maxillofacial surgeon determines that the site of a planned implant requires additional bone mass, he may recommend a bone graft either prior to or in conjunction with the implant placement. Bone grafts may use autologous (the patient's own) bone or an alloplastic or allogeneic bone substitute.
Oral and maxillofacial surgeons commonly use bone grafting techniques as part of facial reconstructive and orthognathic surgical procedures (corrective jaw surgery), often harvesting a slice of bone from the patient's hip, rib, or skull to aid in filling large gaps in the mandibular or maxillary jawbones.
A dental bone graft is a procedure performed, by fully trained oral and maxillofacial surgeons such as Dr. Matthew Hilmi, to increase the volume of bone in a part of the jaw where bone has been lost or where additional support is needed to support a dental implant or other prosthetic dental appliance.
Bone may be taken from elsewhere in the body and surgically fused to existing bone in the jaw. Alternatively, synthetic bone material is used.
A dental bone graft is sometimes needed if further procedures, such as dental implants, are necessary or if bone loss is affecting the health of nearby periodontal tissues and/or teeth.
What exactly is a dental bone graft?
There are many different approaches to placing dental bone graft, but the basic procedure is the same: An oral surgeon makes an incision in the jaw and grafts /places additional bone material to the jaw.
A dental bone graft is usually done if someone has lost adult teeth or has advanced gum(periodontal) disease. The previously mentioned conditions can cause extensive bone loss in the jaw(s).
The preferred approach for dental bone grafting is to use the patient’s own bone from the back of the jaw, the leg, or the hip. This is referred to as an autograft. Autografts are the “gold standard,” increasing bony support in the jaw(s) and promoting faster healing and new bone creation. Dr. Matthew Hilmi will determine with graft source is best foe you during your consultation.
Surgical Graft Materials:
Autografts.: Bone from the patient’s own body, such as from your jaw, leg or hip.
Allografts: Bone from a different person, almost universally a cadaver.
Xenografts: This involves bone from an alternate species, such as a coral, cow, or pig
Alloplasts: Use of synthetic material, such as calcium phosphate or calcium sodium phosphosilicate (Bioglass).
Reasons For Dental Bone Grafting:
Implants for missing teeth
Patients requiring dental implants as a replacement of missing teeth are common candidates for dental bone grafts.
Dental implants are placed in the jawbone. A crown structure resembling the adjacent teeth is then placed and secured to the dental implant.
Dental bone grafting may be necessary to provide a solid foundation for a dental implant. According to recent research, approximately half of the implant sites required bone grafting prior to implant placement.
Tooth loss or gum disease
Even if you’re not receiving an implant, dental bone grafting may be necessary to support a section of the jaw that has lost bone because of tooth loss or gum disease.
Bone loss can start to affect nearby teeth and gum tissue. Stabilizing the jaw with a bone graft can help prevent further bone loss and the long-term health complications that come with it.
If gum disease isn’t managed effectively, it can lead to further tooth loss and even heart disease.
Bone loss
Other candidates for dental bone grafts include those whose appearance has been affected by bone loss. Losing bone mass in the jaw can cause the face to look shorter than it used to.
If the lower jawbone loses bone mass, it can appear to protrude. Without adequate bone structure underneath, them, the lips and muscles around them can change in appearance. The skin in the jaw areas can appear more wrinkled.
Bone loss in the jaw is more common among older adults, just as the odds of developing osteoporosis increase as an individual age.
But a person of any age who has suffered an injury to the orofacial area or experienced problems related to poor oral hygiene or other health problems, such as major infections, may need a dental bone graft, as well.
ARE DENTAL BONE GRAFTS PAINFUL?
A dental bone graft that doesn’t involve harvesting bone material from a patient’s own body is a minor procedure.
You maybe sedated during the procedure, so you won’t feel pain until after the anesthesia wears off. Postoperatively, the pain is usually quite tolerable with over-the-counter pain relievers for the next three to four days.
Prescription-strength pain medications may also be prescribed. Depending on how much work is being done, you may experience some discomfort for several weeks during recovery.
If bone material is obtained from your own body, the recovery can be more painful, as surgery is done in two locations — for example, your hip and your jaw.
The amount of bone that’s harvested and then grafted is usually small, resulting in minimal discomfort.
CHECKLIST:
-Avoid eating or drinking anything 8 to 12 hours before the procedure, depending on the type of anesthesia you’ll receive.
-Check with your doctor about the medications you use, especially blood thinners, which raise the risk of bleeding complications during surgery.
-Arrange for transportation after the grafting procedure.
Dental Bone Grafting Procedure:
You’ll receive local anesthesia before the bone grafting procedure.
Dr. Matthew Hilmi will then surgically cleanse the proposed surgical site
He will then make an incision in the gum(gingiva) to separate it from the bone where the graft is to be placed.
Dr. Hilmi will place the bone graft material between two sections of bone that need to approximate.
The bone graft may then be secured with a dissolvable membrane and/or with small precision milled surgical screws.
The incision is then “stitched together” to enhance the healing process.
There are three common forms of dental bone grafting procedures. Each form is useful for unique circumstances affecting the oral and maxillofacial regions.
Block graft
Bone is typically taken from the back of the jawbone, near your wisdom teeth (or where your wisdom teeth once were).
This is usually done in cases where there’s been significant bone loss toward the anterior area of the jaws.
Sinus lift (Sinus augmentation)
When bone loss has occurred near the upper posterior, allowing inferior migration of the sinus boarders, a bone graft is performed to restore upper jaw stability while the sinuses are also moved back to their proper position.
Socket site graft
The bone graft is done at the same time a tooth is extracted to avoid bone loss that might otherwise occur once the tooth is extracted.
Recovery and aftercare for a dental bone graft
After a dental bone graft, you’ll probably leave Dr. Matthew Hilmi’s office with gauze packed around the incision in your mouth.
You should be given instructions for changing the dressing during the next 24 hours and a prescription for antibiotics to help prevent an infection. You will also be given a prescription for pain relievers and an antiseptic rinse.
ADDITIONAL POSTOPERATIVE SUGGESTIONS:
Application of ice packs to help reduce pain and swelling for the first day.
Eating soft, bland foods for the first few days
Sleeping with your head slightly elevated the first 48 hours to help prevent blood from pooling at the site of the incision
THINGS TO AVOID:
Hot liquids, such as coffee or soup
Hard or crunchy foods, such as nuts
Intense physical activity, such as contact sports, that may put the incision at risk
After a week or so, the dull pain in your jaw should give way to some mild discomfort and should feel like it’s improving.
Your jaw should start to feel normal after a month or so. But it usually takes a few months before your jaw is strong enough to receive dental implants.
Plan on periodic visits to Dr. Matthew Hilmi’s office, including at least one round of X-rays, to check on healing during this time.
COMMON SIDE EFFECTS:
The most common side effects of a dental bone graft are pain and swelling which can be kept to a minimum with ice packs and over-the-counter pain relievers. Prescription-strength medications may very occasionally be necessary for some people.
Other common occurrences include minor bleeding and difficulty chewing and speaking for the first few days.
RISKS:
Using a trained oral and maxillofacial surgeon for your bone grafting procedure will help to minimize postoperative complications. Additionally, if complications should arise the surgeon will know best how to deal with them. Infection can result with any surgical procedure, so it’s extremely important to take the full course of antibiotics. Other unusual (but serious) potential side effects include:
Rejection of the bone graft
Nerve damage
Anesthesia complications
A dental bone graft, placed by an oral and maxillofacial surgeon, is usually a safe and effective procedure. However, complications can occasionally develop.
Pain that persists or worsens several days after the procedure
Redness and increased swelling around the gums
Persistent tingling or numbness
CONCLUSION:
Dental bone grafts are performed to help prevent long-term health problems associated with tooth loss and gum disease as well as to provide sufficient bone material to support dental implants.
Bone grafting is generally safe and well tolerated.
Following Dr. Matthew Hilmi’s instructions during recovery will help optimize your grafts success and minimize your chances of postsurgical complications.