Bone Grafts

Bone grafting procedures are usually necessary if there is not enough bone available to place dental implants or if any vital anatomy is in the way.

Loss of bone volume can be caused by a variety of factors due to :

  • infection
  • trauma
  • periodontal (gum) disease

If a patient lost a tooth and leaves the gap over a long period of time. It is likely that the bone around the lost tooth has degenerated to some degree and needs to be augmented before it can support a dental implant. This is usually a result of bone resorption that has taken place since one or more teeth (if not all) were lost. Bone Grafting procedures usually try to re-establish bone dimension, which was lost due to resorption. .

Many years ago the lack of bone posed a considerable problem and sometimes implant placement was impossible because of that. Today, however, humans now have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width and gives us a chance to restore the esthetic appearance and functionality better. Today, bone grafting procedures have become almost an integral part of implant reconstruction


Types of Bone Grafting

Bone Grafting
Bonegrafting involves adding bone material to the affected area. Bonegrafting procedures can be easily obtained from other areas of the jaw or from pre-packaged bone graft mineral.
Socket Grafting
When a tooth is removed, the bone at the extraction site tends to collapse inward and shrink over time. However, bone can be maintained and even improved by adding bone mineral with a dissolving collagen sponge to the extraction site.
Sinus Grafting

The maxillary sinuses are empty pockets behind your cheeks, above of your upper back teeth. Sometimes after an upper back tooth is removed and the socket heals, only a thin layer of bone will remain under the sinus. When the sinus floor is thin, grafting to the area may be necessary before implants can be placed.

Ridge Augmentation
When teeth have been missing for extended periods of time, the bone remaining in the area may become too narrow and/or too short for implant placement. In these instances, small, carefully prepared and fitted grafts can be placed at the implant sites to provide adequate bone thickness and/or height.


Types of Bone Grafting Materials

With respect to the Bone Graft material used, we have to differentiate between several choices. All materials can be categorized into five different categories:

  • Autograft or autogenous bone graft
  • Allograft or allogenic bone graft
  • Xenograft or xenogenic bone graft
  • Alloplast or alloplastic bone graft
  • Growth Factors

Each of the bone graft materials is usually developed with a specific purpose or advantage in mind. Your surgeon will make a decision with respect to the bonegraft material, based on your individual needs and the latest research in that field.


Procedure for Bone Grafting

  1. First Evaluation and diagnosis
    • An oral examination and x-rays may be taken to determine if bonegrafting is really warranted
    • Relevant medical history are recorded. Do ensure that you report to your dentist any problems with any previous dental experience such as bleeding problems, medical conditions or allergies to medicationsand supplements
  2. Site tooth preparation
    • Local anesthetize is given to "numb up" the tooth, jawbone and surrounding gums
    • Gingival area is opened
  3. Bone Grafting is done
    • Bone tissue material is inserted and sometimes additional manebrane is placed on
    • Stitch up to close surgical site
  4. Instructions on post care directions given
Step 1 & 2
Step 3
Step 4
Bone Graftng Preparation
Gum is loosen and gum material placed in
Care of Bone Grafts


Recovery Expectations

Bleeding should stop within 15-30 min. after operation and may take longer in some case. Patient may slowly sip cold water to help the bleeding stop faster.You may follow your regular daily activities, avoiding excessive exertion typed of activities such as exercising or sunbathing.


Postcare Instructions after Bone Grafting

  • Do not use mouthwash for six hours after oral surgery
  • If mild bleeding occurs, hold cold salt water in the mouth until it warms to body temperature
  • Do not rinse for 12 hours
  • After 12 hours you may rinse with a solution of teaspoonful of salt in a glass of warm water. Antiseptic mouthwash is also recommended to use in the morning and before bedtime
  • Coe-Pack or periodontal dressing is a material of choice which may be used in some operation. This can be removed three days after the surgery by gently peel the rim of the dressing and the white patch can be removed using moist cotton pellet or gauze.
  • Brush your teeth as usual, but do not brush the wound
  • Take only soft, non-spicy and cold foods, if possible, for 2- 3 days
  • Avoid smoking and alcohol
  • Avoid swelling by sleep on the thick pillow during night time.
  • Mild pain can be controlled with pain relieve medications as directed by your dentist
  • Complete taking the course of your prescribed antibiotic medication as directed.
  • Non-absorbed suture should be removed within 7-10 days after the surgery.
  • Contact the clinic immediately if:
    - Excessive bleeding other than slight staining occurs.
    - Severe pain is present.
    - Marked swelling occur.
    - suspect any symptons of allergic reaction.