Dental Bone Graft


In dentistry, there are many instances where the alveolar bone in which teeth are embedded is lost. This bone loss is either due to infection or due to trauma. Dental bone graft is a procedure for increasing the quantity of bone. Bone loss in infection or trauma can be replaced through the process of bone grafting.

Also, dental implants used for prosthetic replacements may need additional support and stability. This support and stability can be achieved through bone grafting.

The function of bone graft is to increase the bone volume, improve the support and stability of dental implants and to improve the esthetics of dental prosthesis.

Bone grafts can be obtained either from humans or from some other species or can be entirely synthetic. Acceptance of bone grafts from humans is faster. However, other bone grafts have their advantages as well.

Types of dental bone grafts

Bone grafts are divided into various types depending on the site from which the bone graft is obtained:

1) Autograft

Autologous or autogenous bone grafting involves utilizing bone obtained from the same individual receiving the graft. Bone can be obtained from the iliac crest, chin or mandibular ramus or coronoid process. Autograft is the most preferred bone graft because there is less risk of graft rejection as the graft is obtained from the patient′s own body.

2) Allograft

Allograft is also obtained from a human. The difference between autograft and allograft is that allograft is taken from an individual other than the one receiving the graft. Allograft bone is taken from cadavers that have donated their bone so that it can be used for living people who need it. Allografts are sourced from a bone bank.

3) Xenograft

Xenograft is obtained from the bone of other species.

4) Alloplastic grafts

Alloplastic grafts are synthetic grafts. They are synthetically made from a naturally occurring mineral called hydroxyapatite.

Why is Dental Bone Grafting performed ?

Bone grafting is widely used due to many reasons. Some of the main reasons are :

1) Restoration of the edentulous area of a missing tooth

2) Restoration of skeletal integrity of bones in which congenital bone defects exist

3) Replacement of segments of bone after trauma or malignant tumor invasion

4) Repair broken bones that have bone loss and repair broken bone that has not yet healed

How to prepare for Dental Bone Grafting procedure

After a thorough clinical and radiographic examination, the dentist decides whether or not the patient needs to undergo bone grafting. A CBCT radiograph is generally taken of the jaws to get a clear view of the site where bone grafting needs to be done. Prior to the surgery, blood tests are done. Details regarding the medical history and medications taken by the patient are noted. The patient will be asked to discontinue blood anti-coagulants if they have been taking them. Also, pre and post-surgical instructions will be given to the patient.

How is Dental Bone Grafting performed ?

The dentist decides the type of bone graft to be used.  The area where the bone graft is to be placed is then anesthetized. Generally, local anesthesia is given while performing a dental procedure. An incision is then made, the area which needs to receive the graft is prepared and then bone graft is placed. The bone graft is held in place with the help of screws, plates, pins, wires or cables. After placing the graft, the site is sutured back. The patients are prescribed antibiotics for the next three days to avoid any post-surgical infection.

What to expect post Dental Bone Braft ?

Since bone grafting is a surgical procedure, some discomfort may be experienced by the patient after the surgery like:

1) Bleeding

2) Swelling and bruising (May take 24-48 hours to peak)

3) Discomfort for several days

4) Numbness due to anesthesia for up to six hours

5) If resorbable suture were placed, they would dissolve

6) If screws were placed, these would be removed at the following appointment, by the discretion of the doctor

Dental Bone graft recovery process

Recovery from bone graft placement takes around six months to one year. This recovery depends on how osseointegration happens. Intake of antibiotics and maintenance of oral hygiene (like brushing and flossing of teeth) will help in quick recovery. Application of ice and having soft food helps avoid trauma, thereby allowing fast healing of the bone. After a period of one week, the sutures can be removed.

The patient, if a smoker, is advised not to smoke after the surgery. Smoking delays the healing process. Also, high rates of bone graft failures are observed in patients who smoke. It also affects bone growth. Improvement in health is seen after smoking is quit.

Also, intake of a balanced diet improves the overall health of the body. Better results after the surgery are observed when a healthy diet is taken.

What are the signs of Dental Bone Graft failure ?

The procedure of bone grafting is generally safe to perform. However, there are some signs which indicate a failure in dental bone graft procedure. These signs are as follows :

1) Bone graft resorption

If the surgical procedure is not performed correctly, there are many chances of the bone graft getting resorbed. In such cases, the process needs to be repeated.

2) Bone inflammation

The site where bone graft has been placed has to be kept free of any type of infection. Any kind of infection can lead to inflammation.

3) Pain

Pain may occur at the surgical site where graft has been placed.

4) Numbness

Nerves close to the site of injury may get injured.

5) Swelling

Failure to maintain an infection free environment can lead to inflammation followed by swelling at the surgical site

What is Dental Bone Graft cost ?

Dental bone graft costs vary according to the type being used. Allografts, xenografts and alloplastic grafts cost around between $200 and $1,200.

For the autografts, the total cost may be between $2,000 and $3,000. Prices are at a premium rate since the use of autografts involves two surgery sites.

Additional References

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