Bone Grafting

When considering dental implant surgery, the integrity of the bone in the area of the proposed implant is critical to the success of the implant. Over a period of time, the jawbone in areas with missing teeth begins to atrophy or reabsorb  back into the body. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In the past, most of these patients were not candidates for dental implants.

Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance.

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. Sinus bone grafts are also performed to replace bone in the posterior upper jaw. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip, or tibia (below the knee.) In many cases, we can use an allograft material to stimulate bone grafting for dental implants. This bone is prepared from cadavers and used to promote the patients own bone to grow into the repair site. It is quite effective and very safe. Synthetic materials can also be used to stimulate bone formation. We also use factors from your own blood to accelerate and promote bone formation in graft areas.

In addition to the grafting material, special membranes may be utilized that dissolve under the gum, protect the bone graft, and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Major Bone Grafting

Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different sites depending on the size of the defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.

Sinus lift procedure

The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. When the sinus wall is very thin, it is impossible to place dental implants into this bone.

There is a solution and it’s called a sinus graft or sinus lift graft. The dental implant surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

These bone grafting surgeries can be performed in the office or in an out-patient surgical suite under IV sedation or general anesthesia. After discharge, bed rest is recommended for one day and limited physical activity for one week.