In order for a dental implant to be successful the patient must have sufficient bone in the jaw to place the implant into. Usually the quality and quantity of bone in the jaw is reflective of how the bone healed after the tooth was removed, and not an underlying medical condition.
It was once assumed that if a patient did not have enough bone in their jaw they would not be suitable for dental implants. Today, thanks to the massive advances in dental techniques and technology patients with insufficient bone in the jaw can have the bone rebuilt using bone grafting.
The actual bone grafting procedure is much more straightforward than you might think. Bone grafting will only take place after your dentist has assessed the quality and quantity of the bone in your jaw and found that there is not enough to continue with a dental implant. Next your dentist will discuss the different types of bone graft with you and decide which will be the most suitable for you.
Once this has been decided the bone graft can be performed. For this the dentist will cut the gum at the site of the bone graft and create flap of skin. When the jaw bone is exposed the dentist will place the bone to be grafted onto the site and cover it with a protective membrane. This membrane is used to protect the bone from any microbiota (germs) found in the mouth and ensure that the area is perfectly clean to encourage the healing process. Finally the flap of gum is replaced and stitched carefully back into place. Healing time for a bone graft can vary from patient to patient but on average it is around 4 months. Patients are also given a course of antibiotics to take in the days following their bone graft. Antibiotic mouthwashes are also prescribed to preserve the health of the gum covering the bone graft.
Dentists can check on the success of the bone graft by performing x-rays to determine the height and width of the new bone. Once this has been confirmed as satisfactory, and the site of the bone graft is totally healed, the next stage of the dental implant process can begin.
Autografts – this is one of the most successful bone grafting techniques. Bone is taken (harvested) from the body of the patient (usually from the hip or the mouth) and this is then grafted onto your jaw bone. As harvested bone comes directly from the body of the patient, autografts tend to be the most successful form of bone graft as the harvested bone is compatible with the jaw bone.
Xenografts – these use bone that is harvested from animals, usually cows. This bone is processed to make it sterile and totally biocompatible. Animal bone behaves like filler and eventually a patient’s body will replace this with natural bone.
Allografts - these grafts are taken from human bone donors in the same way that organs are taken from donors in the event of their death. Bone which is harvested in this way will be put through various tests and sterilisation techniques to ensure that it is safe to be used as a graft. After the donor bone is placed in the jaw bone it will eventually be converted into natural bone and the jaw bone will be rebuilt.
Alloplastic grafts – these grafts are man made from synthetic materials, normally a type of calcium phosphate as this mimics natural bone. Grafts of this kind can be replaced, over time with natural bone as they are resorbed into the body and encourage natural bone growth. Some alloplastic grafts are made from material which cannot be resorbed by the body and instead these will act as a scaffold on top of which natural bone can be built.
Cost of bone grafting
As bone grafting is not usually done as a separate procedure the cost of a bone graft is incorporated into the cost of a dental implant. However having a bone graft prior to a dental implant will make the procedure more costly, your dentist will advise you of this cost during the consultation process.