This term may seem daunting to many, but in reality, it is already a routine procedure forming part of the implantation. It does extend the healing time of the overall process slightly, but it is essential for a durable and aesthetic dental restoration.
What you need to know before dental bone grafting, why it's necessary, and what forms it can take.
The following answered these questions Dr Márta Fülöp MSc. MSc., Head Dentist and Implantologist at NaturaDent.
Why is bone grafting necessary before an implant?
The first and most important question on this topic is why and when dental bone grafting is actually necessary. It should be emphasised right from the start that some people do not require it, whereas in other cases it is essential.
Bone grafting is essentially increasing the volume and structural integrity of the upper jaw or mandible to allow an implanted fixture to be more durable and stable.
Then it is needed if the patient's bone has weakened for some reason, i.e. bone loss has occurred.
There can be many factors behind bone loss, such as accidents, gum disease, tooth extraction, cancerous lesions, advanced age, and various illnesses.
Bone grafting may be necessary mostly due to tooth loss. This is because the jawbone is stimulated by chewing to undergo continuous ossification; however, if this effect ceases, the bone thins and thus becomes unsuitable for the implantation of a dental implant.
Is bone grafting suitable for anyone?
Regarding the topic, one of the most common questions is whether the patient is suitable for bone augmentation. This question can only be answered after a thorough dental examination and assessment, and it also requires a three-dimensional X-ray taken in our surgery – a 3D CBCT scan – on which the area in question can be examined.
However, if someone has good general oral hygiene and their health is adequate, the procedure can usually be carried out, but excessive alcohol consumption, heavy smoking, or severe periodontal disease, among other things, can be contraindications.
What materials are used for bone grafting?
Regarding the materials used, bone grafting can essentially be carried out with three types of materials. These are as follows:
Natural bone graft
In this case, bone tissue, typically of animal origin (most commonly bovine), enriched with minerals, is implanted. This integrates well with the human skeleton, so after its application, it begins to grow almost immediately and fills the deficient areas.
Artificial bone graft
For artificial bone augmentation, synthetic material is used, the most important component of which is hydroxyapatite. This is biologically compatible with bone tissue, so after implantation, it can transform into a solid, bone-like material. However, based on scientific research, it does not transform into bone of the same quality as the body's own bone, which is why at the NaturaDent clinic, we only use methods of natural bone grafting and bone transplantation.
Bone graft, bone block graft
The method of bone grafting, which we frequently use at the NaturaDent clinic, is partly related to natural bone regeneration, and in this case, it involves a type of bone transplant.
The essence is that bone is taken from the back of the jaw or from the area adjacent to the bone graft site, and used to rebuild the defect.
In cases of bone block transplantation, a larger area needs to be replaced. In such situations, a bone cube or block is taken from the posterior part of the jaw and then screwed into the required area. After the healing period, the fixation screw is either left in place or removed. The advantage of this method is that it uses the patient's own bone, which consequently means the body accepts it much better and it integrates more effectively.
How safe are bone graft materials?
A general question in this area is how safe the materials used for bone grafting are considered to be.
At Naturadent's dental surgery, we exclusively use premium-quality materials that have undergone international inspection and certification, thus their safety and biocompatible nature are unquestionable.
When it comes to natural bone grafting methods, safety shouldn't even be in question.
What bone grafting methods are there?
In addition to the materials used, a very important question is what bone augmentation procedures can be applied before implantation? Let's look at the most well-known ones:
Mandibular augmentation
Most often, the jawbone needs to be augmented for implant placement. This can be done when teeth have been missing for years and the jawbone has thinned. It can be used to increase both the width and the thickness of the jawbone.
Uterine suspension
A particularly common procedure is the augmentation of the maxillary sinus, also known as a sinus lift surgery, which is necessary when replacing upper teeth. If the upper jaw is missing sufficient bone quality and quantity for any reason, this solution can be sufficiently long-lasting.
Using it, the sinus membrane is lifted and the bone graft is placed underneath it, which can thus provide a sufficiently thick base for implantation.
Csontpótlási eljárás
The process of bone grafting is now considered a routine procedure, but it still requires great care from the specialist performing the intervention. A sinus lift bone grafting process consists of the following steps:
- The first step is always anaesthesia! The bone grafting procedure itself is painless, requiring only patience and perseverance from the patient.
- Once the anaesthetic has taken effect, the gum is incised, and in the case of a sinus lift, a so-called window technique is used to expose the area to be treated.
- Through this, the treating physician introduces the chosen bone graft material, which was previously stored and heat-treated in a sterile environment, thus guaranteeing it is free from pathogens.
- After the placement of the graft, the bone window is closed. At Naturadent Dental Clinic, we use a membrane derived from the patient's own blood to promote the bone grafting process and healing.
- Finally, we stitch up the incision and schedule an appointment for the patient for a follow-up examination and the removal of the stitches.
The jawbone [or mandible] is a simpler process. Bone graft, where, after opening the area in question, we place a bone substitute material mixed with autologous plasma in the area, and then secure it with a fixed collagen membrane so that it does not move. After suturing the incision, we arrange a follow-up appointment with the patient.
How long does the procedure take?
The duration of a bone graft is a very common question, but unfortunately, there's no concrete answer as it depends on the surgical technique chosen and the patient.
It usually takes an hour to an hour and a half, however, depending on the size of the operated area, it can be two to two and a half hours long. The duration will be agreed upon with the patient during the oral surgery consultation.
Do you have any further questions? Read more about bone graft options atOn the NaturaDent website.
