Bone Grafting
What is a Bone Graft?
Bone grafting induces the body to produce bone in desirable areas
A bone graft is a surgical procedure used to replace or regenerate bone that has been lost or damaged by placing bone material into an area where bone volume (width or height) is insufficient. Bone grafts are commonly used to support dental implants. Over a period of 4 to 8 months, the graft material stimulates the body to produce new bone, eventually being replaced entirely by the patient’s own bone. This process results in the body laying down new bone in the desired area, making bone grafting a crucial step for successful implant placement in regions with limited bone availability. Several types of bone grafts are available. The graft material can be sourced from the patient’s own body (autograft), a donor (allograft), animals (xenograft), or be synthetic (alloplast). At North Peace Dental and Implant Centre, we primarily use donor and animal bone to ensure good biocompatibility while minimizing the need for invasive bone harvesting from the patient.
When is Bone Graft Required?
Situations involving bone loss that may require a bone graft:
Periodontal disease can damage the alveolar bone that supports the teeth, leading to progressive bone loss, infection, and instability of the teeth. When implants are needed in areas with a history of periodontal disease, bone grafting is often required.
Tooth extraction leads to bone loss due to decreased stimulation over a multi-year process. Without the tooth, the bone resorbs over time as it no longer needs to support the tooth. The rate of bone loss varies among patients.
Infections cause bone loss by inducing inflammation and resorption as the body fights the infection. Bone grafting is often required when implants are needed in areas with a history of dental infection.
Bone Graft Complications
Potential complications and management for bone grafting
Insufficient bone growth is a common issue where the graft is successful but does not reach the desired volume (happens often with standalone bone graft without implant placement), in which case additional grafting can be added during the implant placement surgery.
Infection: When a bone graft is not securely placed and food particles enter the area, infection may occur, which could jeopardize the graft’s success. If infection develops, the graft will need to be removed and replaced.
Graft rejection happens occasionally when the body does not properly integrate the graft material. Rejected graft can be reattempted with a different material or technique.
How is Bone Grafting Done?
Know what to expect for various bone graft procedures
Socket preservation is a procedure performed along with a tooth extraction to maintain bone volume, by placing bone graft material into the socket immediately after the extraction. It aims to prevent bone resorption and create a strong foundation for future dental implant placement.
Veneer grafting is used during implant surgery to address minor bone deficiencies by placing a layer of bone graft material over the existing bone and around the implant. This technique improves implant stability and aesthetics by enhancing bone volume, and reduces the need for additional surgeries by combining grafting with implant placement.
Guided bone regeneration (GBR) is a surgical technique used to promote bone growth in areas with insufficient bone, by placing a barrier membrane over a bone graft site to direct the growth of new bone while preventing the invasion of soft tissue. GBR is commonly used to prepare sites for implants with large bone deficiencies.
Sinus lift, also known as sinus augmentation, is a procedure to increase bone height in the maxillary sinus area by lifting the sinus membrane and placing bone graft material into the sinus cavity. This procedure is required when there is insufficient bone in the posterior maxilla for placing implants in upper molars and premolars. See here for more information about sinus lift.