Bone Grafting
The most significant factor determining the success and predictability of dental implant treatment is the quality and quantity of the underlying bone. When the natural teeth are present and being used to chew, the bone surrounding the teeth is constantly being stimulated, which prevents the resorption (or gradual deterioration) of the bone. If a tooth is missing, the bone in that region is no longer stimulated by chewing and therefore resorbs over time. Although the rate of bone resorption varies from patient to patient, an average of 40-60% of original height and width of bone is expected to be lost within the first 2 years after tooth extraction. Even a small amount of bone resorption can result in inadequate space for implant placement.
Bone grafting procedures can be used to prevent bone resorption after tooth extraction or re-create the bone structure of an already resorbed jawbone. This not only gives us the opportunity to place implants, it also gives us a chance to restore functionality and aesthetic facial appearance.
What are the different types of bone grafting procedures?
Socket Preservation Graft (Socket Grafting): After a tooth is extracted, it leaves behind an empty socket in the jawbone where the roots of the tooth used to be. As this empty socket heals, the surrounding bone undergoes a series of changes, called remodeling, which results in the loss of both horizontal width and vertical height. This loss of bone often results in inadequate space for implant placement. Even in cases where implant treatment is not considered, the loss of ridge height and width can negatively affect the bone support of adjacent teeth and soft tissues, as well as the fit and esthetic appearance of alternative tooth replacement options. The remodeling process can be inhibited by placement of bone graft into the empty socket at the time of extraction.
Sinus Lift Graft (Sinus Augmentation): The maxillary sinuses are large empty cavities of air that are located behind your cheeks and above your upper posterior teeth. The roots of the upper molar and premolar teeth are often extremely close to the sinus and may even extend into the sinus, with just a thin layer of bone separating the sinus cavity from the tooth root. When teeth are removed in this region, post-extraction bone deterioration happens not only from the mouth side, but also from the sinus side. If there is not enough bone for implant placement due to lack of bone on the sinus side, a sinus augmentation graft may be necessary. Sinus augmentation raises the sinus floor by gently lifting the sinus membrane and adding bone graft material to develop adequate bone for implant placement. Depending on the degree of bone loss, this procedure can be performed at the time of implant placement or prior to implant placement as a separate procedure.
Ridge Augmentation Graft: In the months after a tooth is extracted, the surrounding bone undergoes a series of changes which results in the loss of both horizontal width and vertical height. This loss of bone often results in inadequate space for implant placement. If there is not enough bone for implant placement, a ridge augmentation graft may be necessary to re-create the bone’s natural contour. Ridge augmentation grafting is often performed as a separate procedure 4-6 months prior to implant placement and can often be avoided by having socket preservation grafting performed at the time of tooth extraction.
What anesthesia options are available for my implant surgery?
For patient comfort we offer three anesthesia options to our patients undergoing bone grafting surgery: local anesthesia, nitrous oxide sedation, and general anesthesia. Anesthesia options will be discussed with you during your consultation visit. All our services are provided in an environment of optimum safety that utilizes modern monitoring equipment and staff who are experienced in anesthesia techniques. More information about anesthesia options can be found on our Anesthesia Page.