The term bone grafting sounds pretty scary... It's not as scary as you might think, in fact it is a good thing and has become a rather routine and painless procedure with a predictable outcome. Most of the time it is done in conjunction with another procedure while you are already numb, such as following a tooth extraction, during an implant placement or it can be done on its own. Let us discuss your options with you at Old Hook Dental and see if a bone graft can help your long term dental needs. 

Tooth extraction is among the most common dental procedures performed along with missing teeth as a frequent condition. When a tooth is removed or lost it leaves behind a hole (tooth socket) lined with a thin wall of bone. The sole, only purpose of the bone surrounding the socket is to support teeth. When a tooth is no longer there, the body responds by seeing the bone as no longer necessary (resorption), it reclaims the minerals and uses them elsewhere. As the bone shrinks the tissue follows along with it losing any shape and anatomic form. This loss of support may affect the stability of adjacent teeth, leading to further tooth loss like a domino effect. That is why it is crucial to protect and preserve bone, it is the support for the rest of your teeth, your entire facial appearance as well as any future restorations. 

The tooth is removed, leaving a socket. The lack of support will lead to collapse of surrounding teeth. 
          

Resorption creates both a functional and cosmetic defect that results in a collapsed appearance and makes replacing those teeth more complicated. There a couple of ways to ensure you don't lose your bone support. 

• Place the tooth back in - usually not possible, especially if the tooth was extracted.
• Place an implant - this will act as a support and trick the body into thinking it needs to keep the bone in place.
  • It is not always possible to place an implant at the time of tooth extraction or loss.
• Place a socket preservation graft - When an implant cannot be placed immediately, it is ideal to place a socket graft.
  • This graft will fill in the void left by the tooth, hold its place and provide a scaffold for your body to build its own high quality, living, natural bone.

The tooth is removed, leaving a socket. Bone grafting fills the socket and is replaced by natural bone which preserves the space. 
          

How is bone grafting done? 

• Minor graft : A minor graft is performed when a tooth is removed or has been lost recently. The bone grafting material is immediately packed into the remaining socket. Once the material has been packed a protective collagen membrane is placed over it (to hold in the granules in place) and sutures close the tissue.
• Moderate graft : If the tooth has not recently been extracted but rather was lost years ago, there is already likely to be bone loss. In this case, we are not only preserving bone but in addition trying to build it back up. The procedure is similar but slightly more involved. Since we do not have an open socket an incision is placed to gain access, the bone surface is prepared and the grafting material is placed. A membrane is positioned to keep the grafting material secure and sutures close the tissue.  
• Major graft : This type of procedure is not performed at Old Hook Dental due to its extensive nature. It will require harvesting bone from other areas of the body such as jaw or hip.
• Healing : Over the next few months, the bone graft material will be used as a scaffold for your body to build new, living bone of your own. However, this is not a permanent solution, some form of restoration must be placed following healing for the bone to remain. Implants or other types of beautiful restorations can be placed once it has healed. 

Where does the bone come from?

• It can come from a variety of sources, including your own body. While using ones own bone is obviously the gold standard there are other alternatives that do not require a second invasive procedure that will produce similar results.
  • Laboratories process 3 types of bone grafting material. Bovine bone is taken from cows, Human bone is taken from donors, and Synthetic bone is made from hydroxyapatite and/or calcium - minerals found in natural bone.
  • All types are processed and undergo intense safety screening to ensure they are sterilized and devoid of all organic material, leaving behind nothing but the raw building blocks for bone. 
• All 3 types have been used successfully for years in dental grafting procedures and have been proven to be extremely safe.
• Bone grafting material cannot be rejected by the body because it contains no organic material, the only variable is how much of your own living bone will be generated by your body in response to the procedure.
• The actual grafting material placed does not remain in your body forever, it is replaced by your own living bone

When should I have a graft done?

• When a tooth is being extracted - (for socket preservation or implant preparation)
  • Bone grafting should be done immediately following (for the best results).
  • Bone grafting can be done at a later time. We expect some bone loss to have already occurred. 
• When an implant is being placed - (implant preparation)
  • Depending on the starting scenario, grafting may not even be needed.
  • Provided the implant is being buried to heal, grafting can be done simultaneously.
  • Grafting can be done prior to implant placement in preparation and left to heal.
• In both scenarios, following the procedure you should feel back to normal in a day or two, however regeneration of new, live bone can take several months. 

Call to schedule your appointment with us at Old Hook Dental (201) 358-5005