Surgical Services

Bone Grafting

Bone Grafting Overview

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With the loss of teeth, there is an ongoing loss of bone structure; this process is called atrophy. This condition will result in less bone for dental implants. In some cases resorption is severe, making replacement of teeth difficult and implant placement impossible.

Treatment Options

Today there are many ways to treat bone defects depending on the type and amount of bone needed. In our practice, immediate grafting is provided at the time of extraction.

This relatively simple procedure will help maintain the width and height of bone for later treatment. The bone is usually either human donor bone or bovine bone or a combination of the two. Other moderate size defects can be treated using similar materials.

Large defects can require bone from specialized tissue banks or from other parts of your body. The hip is a traditional site for bone collection however the tibia (below the knee) and the skull can also be used. Most surgeries can be completed without the need for such treatment.

Procedures

We utilize 5 common bone grafting procedures. All procedures can be accomplished in a comfortable manner in our out patient facility:

  • Socket grafts
  • Ridge expansion with particulate grafting
  • Ridge expansion with block grafting
  • Sinus elevation grafting
  • Platelet rich plasma
  1. Socket grafts are donor bone material placed into a new extraction site. The walls of the defect must be debrided and all soft tissues removed. This area is covered with a resorbable material and your soft tissues (gingiva). There is usually a 4 month healing period.
  2. Ridge expansion with particulate graft: This procedure is designed to make more width for implant placement. The jaw surface is roughened slightly to cause bleeding; a bone paste using human donor bone, bovine bone, and small amounts of local bone is prepared. Platelet rich plasma can be added as well. This bone paste is then placed on the side of the jaw and covered with a resorbable membrane and your soft tissues (gingiva). This graft is initially fragile; exercise and diet restriction will last for several weeks. There is a 5-6 month healing period.
  3. Ridge expansion with block bone: This procedure is designed for larger defects. The block of bone can be taken from the chin area or the side of the lower jaw. It can also be obtained from a specialized bone bank. The block is secured with tiny screws. Platelet rich plasma (PRP), membranes and bone products can also be used to enhance the results. There are restrictions to your exercise and diet for several weeks. There is a 4-6 month healing period.
  4. Sinus elevation graft (sinus lift): This procedure has been commonly performed since 1990. The cheek bone area is hollow. This area is called the maxillary sinus. The roots of some teeth extend into the floor of the sinus. The sinus wall is very thin and can be treated directly and delicately. Most people will need additional bone in these areas to provide support for implants. Some patients will need to have the sinus floor bone graft as a separate procedure and implants placed several months later. We strive to provide both treatments simultaneously if possible.
  5. Platelet rich plasma (PRP): Healing is initiated by cells in our blood. Platelets, small white blood cells, produce growth factors which initiate and accelerate healing. Using new technology, platelets can be obtained and concentrated in our facility. A small sample of your blood (1 – 3 ounces) can provide sufficient platelets to enhance your healing. The PRP is then mixed with your graft to stimulate the healing process. The growth factors (specifically PDGF*, TGF* and ILGF* stimulate your stem cells to create new bone.

*PDGF – platelet derived growth factor
*TGF – transforming growth factor Beta
*ILGF – Insulin like growth factor