Bone grafting broadly refers to a number of surgical dental procedures whose goal is to rebuild lost natural bone. Bone grafting is most commonly done in preparation for implant placement. Less commonly, bone grafting can be done for cosmetic reasons in preparation for dental bridges, particularly on anterior teeth.
Gross decay, abscess, periodontal disease and trauma are the primary causes leading to the necessity for a bone grafting procedure.
When a tooth has a poor prognosis for restorability, it must be extracted. After an extraction, there is an empty socket where the natural tooth was. If a bone graft is not placed at the time of extraction, within 2-3 years the jaw bone surrounding the missing tooth shrinks by a striking 60% as compared to pre-extraction levels. Bone loss leads to a host of serious cosmetic and health issues – a receding jawline, a collapsed bite, loose and shifting teeth.
Bone grafting helps to preserve the dental socket and the surrounding bone. It also allows for a successful placement of an implant at a later time. Depending on the extent of bone replacement required, the bone grafting procedure may necessitate one or two separate surgeries, or alternatively be done at the same time as the implant placement.
Bone grafting surgery is most commonly completed in a single visit to the office, with the follow up appointments requiring another one or two quick visits.
- The patient is numbed using local anaesthesia in the area requiring bone grafting.
- If a natural tooth must be extracted, the extraction is done first. Granulation and/or infected tissue, if any, is removed.
- The bone grafting material is placed inside the tooth socket. The bone grafting material is made of bovine or cadaver harvested bone, processed at high temperatures or using the freeze-dry method. These processes demineralize and de-proteinize the donor material in order to minimize the opportunity for transplant rejection.
- A protective membrane is placed over the bone grafted site to isolate the graft from contact with the soft tissues and the oral environment.
- The gum tissue is sutured.
In the weeks following the surgery, bone grafting material acts as a scaffolding where the body naturally forms new bone via depositing calcium and other minerals at the graft site. This processes is often referred to as calcification.
- About one week following the bone grafting surgery, the site is checked to evaluate the healing progress
- About two weeks following the bone grafting surgery, all sutures are removed
- About 3-4 months following the bone grafting surgery, the site is evaluated to determine if sufficient new bone has developed at the bone grafted site, or if additional bone grafting may be needed before proceeding with the implant placement.
The patient will be given personalized post-operative instructions after the surgery to follow for the first 2 weeks.
Once the sutures have been removed, the patient can go back to normal oral hygiene, including brushing, flossing and a regular professional cleaning. Extra care must be taken to prevent trauma and infections while the bone graft is maturing.
Insurance coverage for bone grafting varies significantly across dental plans, and some plans don’t offer coverage at all. The best way to determine the insurance coverage for bone grafting is by submitting a pre-authorization request. The office of Dr. Mazen Natour will handle all insurance matters for its patients. Please call us if you have any questions about your coverage.