About Bone Grafting
What is Bone Grafting?
Healthy normal teeth have are supported by healthy bone. The healthy bone is covered by healthy mucosa (gum tissue). Infection in the jaws from failing teeth creates bone loss about the tooth and adjacent teeth. Often healthy gum tissue is also lost. When a tooth is removed and the infection has been removed, we are left with variable bone defects in the remaining jawbone. As this bone heals following the extraction it shrinks further, creating an even bigger bone defect.
Socket preservation bone grafts are designed to try to minimize bone shrinkage and to promote better bone healing in the compromised bone. These grafts are designed to preserve what bone is left but they do not build up the bone like it once was when the teeth and bone were completely healthy.
Bone Loss following tooth extraction
Some bone defects cannot be corrected by just a socket preservation graft. A larger bone graft is needed to provide not only a larger volume of bone but also bone of good quality and healing ability. In the past we have been very limited in what we can do to reconstruct these defects.
Fortunately, today we can treat most of these defects. Various bone-grafting techniques are utilized. This not only gives us the opportunity to place implants of proper length and width, but it also gives us a chance to restore functionality and aesthetic appearance. Most of these grafts are performed in the office, usually with intravenous sedation. The techniques used are designed to be as minimally disruptive as possible for both the tissues and the patient.
These more advance bone defects require different bone graft procedures and are summarized below. Please see each section for more specific information.
- Ridge bone graft augmentation
When the bone is deficient in width or height a bone graft is used to widen the bone or build the bone vertically to reconstruct the lost bone.
- Sinus floor bone graft
When the sinus floor is low or the remaining bone below the sinus is inadequate for implants the sinus floor can be raised internally with a bone graft to provide adequate bone for the implant. Various techniques are available.
- Bone ridge expansion
If the ridge of bone is narrow sometimes the bone can be internally expanded with placement of implants and a bone graft.
Types Of Bone Grafts
Autogenous Bone Graft
Autogenous bone grafts, also known as autografts, are made from your own bone, taken from somewhere else in the body. The bone is typically harvested from the chin, jaw, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is your own live bone, meaning it contains living cellular elements that enhance bone growth.
However, one downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on your condition, a second procedure may not be recommended.
Allogenic Bone Graft
Allogenic bone, or allograft, is bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on it’s own. Rather, it serves as a framework, or scaffold, over which bone from the surrounding bony walls can grow in to replace the original bone graft material that was placed. Patients may have concerns about the safety of human bone bank bone. There are many types of cadaver bone to choose from. However, Drs. Blecha and Jandali only uses specific bone graft materials from specific bone banks that he trusts for their selection of patients. Furthermore Drs. Blecha and Jandali only uses materials that have had clinical research and proven effectiveness for his patient’s. These tissue banks process the bone in a manner that eliminates all cellular components of the original bone bank bone (cells, viruses, bacteria) to leave a matrix void of anything living. They also sterilize this bone matrix so we are using a sterile product. These products are usually used with platelet rich growth factors from the patient which stimulate the growth of the bone graft.
Xenogenic bone is derived from non-living bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenogenic grafts serve as a framework for bone from the surrounding area to grow and fill the void. As with human bone bank bone, Drs. Blecha and Jandali only uses specific xenogenic bone grafting material which have proven clinical documented safety and success for his patient’s.
Drs. Blecha and Jandali has a special interest in bone grafting materials and research over the past 30 years and continues to follow bone grafting development and research for optimum ways to manage each patients bone defect.