BONE GRAFTING

Tremendous advances in bone grafting and guided bone regeneration (GBR) in the jaw bones and around teeth have led to new and expanded areas of treatment. Bone grafting is a surgical procedure that replaces missing bone with a material called a bone graft. This material not only replaces missing bone but also helps your body regrow lost bone. GBR is a procedure in which a membrane is placed over the bone graft site. This membrane further encourages new bone to grow and also prevents the growth of scar tissue in the grafted site. Bone grafts and GBR are needed when a part of your body is missing bone. This missing portion of bone is frequently called a “bony defect”.

Examples of jaw bone defects requiring bone grafting and GBR:

  • Defects surrounding roots of teeth (periodontal defects)
  • Defects which occur following tooth extraction
  • Generalized decrease in quantity of jaw bone from trauma or long-term tooth loss
  • Defects surrounding dental implants
  • Defects resulting from cyst or tumor surgery

Bone Grafting Periodontal Defects Around Teeth

Your jawbone is what supports your teeth and gums. Advanced periodontal infection breaks down parts of your jawbone surrounding the roots of teeth. The first step of treatment is to gently fold back the gum tissue and thoroughly remove the bacteria from the bony defect. Then, bone graft material is filled into the space where bone has been lost. The bone grafting material may be your own bone, synthetic bone or sterilized bone from an accredited tissue bank. Tissue stimulating proteins may be added to promote more rapid healing. A resorbable collagen membrane may also be placed between the gum and bone graft to encourage new bone formation and prevent the growth of scar tissue into the grafted site. New bone tissue fills in the bony defect providing strong support for the tooth.

Bone Grafting & Socket Preservation After Extraction

When a tooth needs to be extracted, bone grafting of the socket is recommended for temporary stabilization and preservation of the existing bone in that area. Ridge preservation can potentially minimize the amount of bone loss that occurs between the time of tooth removal and implant or bridge placement, as compared to leaving the socket empty.

First, the tooth is carefully removed and the remaining tooth socket is thoroughly cleaned of all inflamed and infected tissue. A protective membrane may be placed in the socket before adding bone grafting material. The bone graft material is placed into the extraction socket. A collagen membrane barrier is often placed over the grafted material. During the healing process, the graft material is intended to act as a scaffold and be replaced by your own new bone, creating a secure location for the implant to be placed.

Ridge Augmentation

Bone grafting is used to prepare a site for dental implants that are needed to replace a missing tooth or teeth. Bone, in an area where teeth have been lost, naturally shrinks or resorbs over time, both in height and width. As a result, new bone must be grafted to create a secure site for placing implants and to achieve esthetic results.

For the bone augmentation procedure, an opening is made in the gum area where bone is needed. The grafting material and tissue stimulating proteins are gently placed within the grafting site, alongside the existing bone, and stabilized with a protective membrane barrier. Allografts (donor grafts) may be used in place of your own bone, with no additional surgery required. During the healing process, the graft material is intended to act as a scaffold and be replaced by your own new bone.

The risk of bone loss can be reduced by replacing lost teeth quickly, before significant bone loss occurs. If you are not ready for dental implants at the time that your teeth are lost or removed, a ridge preservation procedure is recommended to maintain the bone in that area until your implants can be placed.

Sinus Augmentation (Lift)

A Sinus Lift is often required as a first step when placing a dental implant in the back of your upper jaw. It is a bone grafting procedure that is required when there is insufficient bone height in the area of your upper molars and premolars to accommodate the length of a dental implant. A sinus lift, sometime called sinus augmentation, adds bone between your jaw and the maxillary sinus. The sinus must be moved upward, or “lifted” to create space for the bone grafting material.

There are several reasons why the position of the sinus in the upper posterior areas may be too low for the placement of dental implants. A frequent cause is the size and shape of the maxillary sinus may be large in comparison to the size of the upper jaw. The sinus size can get larger as you age. If teeth have been missing for a long time, bone in that area naturally shrinks or resorbs over time. Consequently, your sinuses expand to occupy the empty space where the bone used to be. Periodontal disease may have led to a loss of bone as well.

At present, sinus grafting with lateral window sinus lift procedures and osteotome internal sinus lift procedures are being used to regenerate and increase bone volume in the (upper posterior jaw) before implant placement. Your procedure will depend on the amount of bone you have left.

  • Lateral Window Sinus Lift – When there is minimal bone height, a side/lateral window opening is created in the bone to access the sinus cavity. Then the sinus is gently lifted and the bone grafting material is placed beneath the sinus membrane alongside the existing bone. Allografts or xenografts may be used in place of your own bone, and mixed with proteins called growth factors to stimulate bone formation. A protective membrane barrier is placed to cover the lateral opening in the bone. Sometimes the implant can be placed at the same time the sinus is augmented. Otherwise, healing time is approximately 6 to 9 months before implant placement. During the healing process, the graft material is intended to act as a scaffold and be replaced by your own bone.
  • Osteotome Internal Sinus Lift – The osteotome sinus lift technique is an internal approach where bone graft material is added through the same channel following bone preparation for implant placement. The bone remaining under the sinus floor is gently “pushed up” thus lifting the floor of the “dropped” sinus. The bone grafting material is then placed beneath this lifted bone to allow implant placement usually at the same appointment. This internal sinus lift technique is possible when pretreatment bone heights are about 5 to 7 mm.

We accept all major credit cards:

Also, for your convenience,
we offer financing through CareCredit: