Bone grafting is often closely associated with dental restorations such as bridge work and dental implants. In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended for the ensuing restoration.
There are several major factors that affect jaw bone volume:
Periodontal Disease – Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
Tooth Extraction – Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site during the following three years. Loss of bone results in what is called a “bone defect”.
Injuries and Infections – Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.
Reasons for bone grafts
Bone grafting is a highly successful procedure in most cases. It is also a preferable alternative to having missing teeth, diseased teeth, or tooth deformities. Bone grafting can increase the height or width of the jawbone and fill in voids and defects in the bone.
There are essentially two basic ways in which bone grafting can positively impact the health and stability of the teeth:
Jaw Stabilization – Bone grafting stabilizes and helps restore the jaw foundation for restorative or implant surgery. Deformities can also be corrected and the restructuring of the bone can provide added support.
Preservation – Bone grafting can be used to limit or prevent bone recession following a tooth extraction, periodontal disease, or other invasive processes.
Initially, Dr. Martone will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. If periodontal disease is present or the adjacent teeth are in poor condition, these factors will be fully addressed before the bone grafting procedure can begin. Dr. Martone will also recommend a focused CT scan in order to assess the precise depth and width of the existing bone.
What Does Bone Grafting Involve?
There are several types of bone grafts.Dr. Martone will determine the best type for your particular condition.
Autogenous Bone Graft - Harvested from the patient’s own body (usually from the posterior part of the lower jaw or the chin). This method is usually preferred because it produces the most predictable results.
Allograft Bone Graft - Cadaver or synthetic bone is used in this type of graft.
Xenograft - Cow bone is used in this type of graft.
Bone is typically harvested from your own body (or on rare occasions obtained from a “bone bank”) and added to the affected site. This bone will fuse with the existing bone and the migration of cells will cause firm adhesion and cell growth. Supplementing the jaw with bone will result in greater bone mass to help support and anchor the implant(s).
During the surgery, Dr. Martone will numb the grafting and extraction sites using local anesthetic. A small incision will be made to prepare the site for the new bone and it will be anchored into place. On occasion, a synthetic membrane may be used to cover the new bone. This membrane prevents soft tissue and bacterial invasions, and encourages new bone growth. The surgery does not require an overnight stay, and you will be provided with comprehensive instructions for your post-operative care. Dr. Martone will prescribe medications to help manage infection, discomfort and swelling.
Alveolar Ridge Augmentation
What is Alveolar ridge Augmentation?
Alveolar Ridge Augmentation is a surgical procedure done to improve the shape and size of the alveolar ridge(s) in preperation to receive and retain a dental prosthesis. It may be localized, as in socket grafting or it may involve the entire ridge.
What Is A Localized Alveolar Ridge Augmentation?
Localized alveolar ridge augmentation, also referred to as socket grafting or grafting of a buccal wall defect, is a common dental surgery that may be performed following the extraction of a tooth to help recreate the natural contour of the gums and jaw that may have been lost due to bone loss following, or as part of, a tooth extraction.
The alveolar ridge of the jaw is the bone that surrounds the roots of the teeth. When a tooth is removed, it leaves behind an empty socket in this bone. Typically, this empty socket will heal on its own, filling in with bone and tissue. Sometimes the walls of the socket are thin and break during tooth removal, or were missing before the procedure. When the bony wall holding the tooth into the jaw on the side facing the cheek is missing, it's called a "buccal wall defect." These types of sockets typically do not heal to their previous height and width because they do not have intact, bony walls to guid bone regneration. Bone typically will continue to be lost at this site, because there is no tooth to retain the bone.
Rebuilding the original height and width of the alveolar ridge is not critical to the patient's overall health, unless the patient wants to replace the original tooth with a dental implant or the lost tissue has caused an aesthetic problem. Dental implants require a certain amount of bone to support the base of the implant. Patients who are considering a dental implant may want to consider a synthetic recombinant protein grafting option in the socket to maintain the alveolar ridge height and width and enable future implant placement. Placing this type of graft material into the tooth socket has been shown to promote bone growth, prevent bone resorption after tooth extraction and preserve the height and width of the alveolar ridge. One of the primary advantages of socket grafting is that it allows implant placement.
How Is It Done?
A ridge augmentation procedure is performed by placing graft material into the tooth socket. This may be done immediately after the tooth has been removed. The gum tissue is then advanced over the socket and sutured.
Once the socket area has healed, the alveolar ridge can be prepared for a dental implant or other dental restoration.
Dental implants are designed to serve as the foundation for artificial teeth (crowns) that look, feel and function like natural teeth. Dental implants typically are very small, screw-type posts placed into the jawbone where teeth are missing. The bone bonds with the post, creating a strong foundation for artificial teeth. Dental implants help preserve facial structure and also help prevent the bone deterioration that usually occurs when teeth are missing.
A ridge preservation procedure typically is performed in the dental office under local anesthesia, however, some patients also may request sedative medication, as well.
What about the entire ridge?
The entire bony ridge may be augmented by basically the same technique used over a more extensive area. This may be accomplished with either a particulate material or a block graft material. It may be autogenous (patient's own bone) or it may be synthetic and or cadaver bone.
Dr. Martone may use a single graft material or a combination of materials together with Platelet Rich Fibrin or PRF.