Bone Grafting

It is not unusual for the patient to present for a consultation at the oral surgeon’s office and be informed at some point in the discussion that he or she may require a “bone graft” in order to maximize the outcome of dental implant surgery. While this sounds pretty scary at first, the truth is that bone grafting in the oral cavity today is a routine, predictable and painless procedure.

 

Bone Grafting for Dental Implants

While the need for bone grafting has been significantly reduced, it has not been eliminated entirely. However, in most cases it is now relegated to small minimally invasive interventions that can be managed quite easily in an ambulatory (office) setting. Furthermore, while bone grafting of earlier years involved harvesting and using large quantities of the patient’s own bone (autogenous grafts), today we can often use processed bone that has been harvested from animals (i.e., cows). These grafts are termed xenografts and are generally comprised only of the mineral content of natural bone, have been sterilized and have had all organic material removed. Using bovine bone (cow bone) as a graft material has become commonplace in most oral surgical offices today and has been a tried and proven technique for many years. A simplified explanation for the success of this form of grafting is that a bovine bone graft is placed to act as a “biological placeholder.” Initially, it mechanically prevents the collapse of the surrounding tissues, whether that is bone or soft tissue. Then, through a process called “guided tissue regeneration,” the human body is fooled biochemically to recognize the graft as natural bone and over time resorbs and replaces it with the patient’s own native bone.Although major autogenous bone grafts are still occasionally required to provide a home for dental implants, the most common bone grafting required involves one or a combination of the following three simpler outpatient procedures:

• The Alveolar Ridge Preservation Graft or “Socket Graft”
• The Autogenous Ramus/Chin Graft or “Block Bone Graft”
• The Subantral Graft or “Sinus Lift Procedure”

When considering dental implants as an option, it is a likely possibility that your surgeon will discuss one or a combination of these grafts with you as a pre-requisite to optimize your treatment plan. Therefore, an explanation ensues below to clarify what each of these grafts is for and how they are typically accomplished.