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Bone Graft Surgery

Bone Graft Surgery

This is the process in which the dentist uses bone grafts to build up a thin or shrunken jawbone. If you are considering an implant but dental x-rays and/or CAT scan show that you have a thin jawbone as a result of bone loss then a graft will be necessary. For more information on what is involved in the procedure follow the link: Bone Graft Procedure

Your jaw may show advanced bone loss as a result of the ageing process, prolonged denture wear, missing teeth, periodontal gum disease or as a result of an accident.

What causes bone loss?

If you lose a tooth through accident or injury then what tends to happen is that the area around the missing tooth recedes and the jawbone itself starts to shrink.

Our teeth help to maintain bone density by a natural renewal process. This ensures normal bone growth and healthy tooth tissue.

Another factor is that of aesthetics: if a person has lost several teeth and has not replaced them then their facial jaw line will appear lined and ‘sunken in’. This aged appearance is both undesirable and unnecessary.

One way of preventing this is via a dental implant but this may have to be combined with a bone graft.

Bone grafts are a recent innovation and are highly successful. They involve the grafting of bone from one area of your body into your jawbone to increase its width and depth.

Ideally, bone will be grafted from your own body although a synthetic alternative can be used.

Types of Bone Graft

There are four types of bone grafts:

  • Autogenous or Autografts
  • Allografts
  • Xenografts
  • Alloplastic

Autogenous

This is the most popular and successful of all the grafting techniques and is often referred to as the ‘gold standard’ in bone grafting. It involves the removal or ‘harvesting’ of bone from a designated donor site such as the hip.

The hip is the preferred source as this is rich in marrow which means a ready supply of bone cells.

This bone is then grafted into the jawbone.  

This is the most successful of all four techniques as the grafted bone aids with the regeneration of the jawbone.

Allografts

This is similar to an autogenous graft in that it uses natural bone, although this is taken from a human donor rather than a part of your own body. There are special ‘bone banks’ for this purpose where people have donated bone samples – which are very similar to blood banks.

If you are not keen to have an autogenous bone graft then this is an option. The donor bone is taken from a source of human cadavers via a special ‘bone bank’ and is rigorously checked and sterilised before grafting takes place.

Donated bone is tested and then sterilised before being grafted into your jawbone. Your body then assimilates this donor bone into your natural bone (of your jaw).

Xenografts

This is a third option: The difference between this and the other two procedures is that the donated bone is harvested from animals rather than a human donor.

Bovine (cow) is the preferred form of animal bone for this graft. You may feel uncomfortable about this and worry about the safety aspects but this undergoes a system of rigorous testing beforehand. This is to ensure that it is sterile and compatible with your anatomy and bone composition.

This grafted bone acts as a ‘stand in’ which your body will replace with natural bone over time. This formation of new bone is called ‘Osteoinduction’ which uses a special protein called Bone Morphogenic Protein (BMP) to initiate this response.

For further information on this type of Bone Graft please click on the link below:

http://www.geistlich.co.uk/?dom=1025&rub=2502

Alloplastic

This is the fourth technique in the bone grating series. This differs from the other three in that it is a man made graft rather than natural bone.

This graft is a synthetic version, made of calcium phosphate which looks almost identical to natural bone. There are two types of alloplastic grafts:

  • Resorbable
  • Non-resorbable

A resorbable graft means that it will be replaced by natural bone by your body. This doesn’t happen with the resorbable type of graft but it can still be used to form a structure to hold the implants. This formation of a structure or ‘scaffold’ applies in both cases. 

If you require several implants then the amount of bone to be grafted will increase in proportion to the number of implants.

This procedure is usually carried out in hospital and requires an overnight stay.

Bone grafting is a very successful procedure although you do need to know that like all procedures there is a tiny risk of rejection. We cannot be 100% certain as to why this happens although we can highlight contributing factors such as smoking and certain medical conditions. These can predispose the patient to this risk.

Bone graft failure can happen as a result of an infection or as a result of the grafted bone becoming loose and refusing to stabilise in the jaw.

If you experience bone graft failure then you will have to undergo removal of the rejected graft followed a period of healing before a second graft can take place.

There are other techniques available which can help with bone loss such as a sinus lift or elevation, ridge expansion and distraction osteogenesis.

Bone Grafting Procedure