Bone Grafting For Implants

The succcess of an implant is based upon its bonding with the bone around it. When implants and bone bond with each other the process is called integration. In order for this to occur it is necessary that the bone into which the implant is being placed be healthy and of adeqaute size and firmness or density. Many areas where implants are needed are lacking in some of these qualities. Often the reason for this deficiency is related to the loss of the tooth or teeth that were originally in that site. In the early years of dental implant surgery this meant that implants could not be placed. Scientific advances over the last fifteen years have made it possible to regrow bone in many of these deficient areas and allow for implants to be placed successfully.

Bone grafting involves preparation of the intended site and then the addition of graft material. That material may either fill a space or add on to a missing level of bone. While some bone grafts require that the patient’s own natural bone be moved from one area (the donor site) to another (the receptor site), most of our procedures are performed with graft material that comes from commercial sources. This involves using a bone replacement material out of a bottle, thus sparing our patients a second surgical site for the donor graft.

In these cases, the receptor site is made completely numb with local anesthetic. As with all our surgeries, sedation is also available to our patients where medical conditions are suitable and patitients require more than local anesthesia. In either case, the site is filled with graft material and then closed in a proper fashion using sutures. The time that it takes the grafted bone to form solid healthy bone for implants will vary according to the location and degree of bone loss. It is safe to say that a minimal period would be 3 months and the ususual maximum would be 6 months. Patients are advised of the period suitable to them prior to the procedure.

When the bone graft has matured it is treated as if it were normal bone. At that time implants may be safely placed and should have the same good chance for success as if the bone had been there originally.

When bone grafting is indicated it is usually determined during the implant evaluation visit. At that time, the doctor will discuss the need for grafting, the particular method suitable, time frames and associated fees. In this way patients will know in advance what is to be involved in their treatment.

Sinus Lift Procedure

The sinus lift is a particular type of bone graft. It is performed using commercially available bone sources and does not require a patient donor site. Optimally, the healthy maxillary sinus is an air space that exists in the upper jaw, above the roots of the upper teeth and below the eye socket. Since there is no bone in this space, it is unable to support an implant. Replacement of missing upper molar and premolar teeth often requires such grafting when the dnetal bone below the sinus has limited height. The object of the sinus lift is to place a graft between the floor of the sinus and the dental bone below it. This effectively increases the amount of usable dental bone to accept an implant or implants. Since the sinus is quite large and the implant is quite small, the fractional amount of elevation is minimal and does not affect the functioning of the sinus.

The maxillary sinuses are paired, with one on each side of the upper jaw. In order to enter the area necessary for the graft, a small opening is made in the gum of the intended region and at the end of the procedure it is closed with fine sutures. The procedure is usually performed with local anesthesia to completely numb the site. As with all our surgeries, sedation is also available to our patients where medical conditions are suitable and patitients require more than local anesthesia. The graft is left in place for approximately six months and is then checked with x-rays. When the graft has matured implants may be placed.

A good medical history with specific emphasis on sinus health, along with proper pretreatment x-rays is necessary before considering sinus grafting for any patient.

Ridge Expansion

Ridge expansion is another form of grafting that is used when the dental bone in the region needed for implants is too narrow. In these cases the inner and outer walls of the ridge are separated as two sides of a sandwich. The bone graft is then placed between the walls to make a thicker sandwich. After complete healing of about six months, implants may be placed in the wider dental ridge.

Bone Grafting Overview

For a brief narrated overview of the bone grafting process, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about bone grafting.

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