Why is dental bone grafting done?
At Harvest Dental, we do bone grafting procedures to gain or preserve bone quantity.  When bone grafting is done immediately after an extraction, it is called socket preservation, or alveolar ridge preservation (ARP).  We perform this procedure because studies have shown that after a tooth is extracted, the surrounding bone will resorb (diminish) between 30-60% during the first six months of healing.  If a socket preservation bone graft is done following an extraction, it greatly reduces the amount of bone that is lost.  Preservation of your bone ridge allows us to place a dental implant, or provides a denture or partial a broader more a comfortable and supportive ridge.  If you have had an extraction months or years ago you may notice how that area of your jaw caves in or has a divot.  This is a case where a bone graft can be added to regain thickness of the bone ridge. This is called ridge augmentation.  After a successful augmentation, an implant can often be placed, allowing a patient to gain a tooth where one has been missing for years.

What are the different types of bone grafts available?
There are four main types of grafting; Autografting, Allografting, Xenografting and Alloplastic grafting.  Below, you will find a brief description of all four, although we only place allografts and xenografts.

Autografts:
Autografting describes the process of taking bone from another part of the patient’s body (usually the hip bone, or a section from the lower jaw) and inserting it into the mouth.  This type of grafting has a high success rate as the graft material is already compatible with the implant site.  I do not provide this type of graft because it is very painful, and very expensive.

Allografts:
This form of grafting uses donor bone from another person, in this case, a cadaver.  It is highly successful because of its compatibility with the bone of the patient.  Although this may sound unappealing, this bone material goes through many test, and sterilization procedures.  This material is the number one choice of most physicians and dentists who place bone grafts, due to the high success rate and non-existent cross contamination from donor to recipient.  This method is non-invasive (less painful) and it having the highest success rate of all graft types other than autografts.

Xenografts:
In a xenograft, bone tissue taken from an animal as opposed to a human body.  The success rate of this type of graft is not as high but still very good.  The lower success rate is since this bone is from an animal and its less compatible than that from either the patient’s body or from another human being.  We only use this grafting material if the patient insists on not having donor bone from a cadaver.

Alloplastic Grafting:
These are made from synthetic materials, usually calcium phosphate, which mimics natural bone.  Over time these are resorbed into the body and as they encourage natural bone growth, the patient’s own bone tends to replace the grafted material.  This grafting material is not designed to accommodate dental implants, and therefore I do not use it.

What are the steps in a bone grafting procedure?

  1. An extraction is performed, or an incision is made at the graft site.
  2. The graft site is prepared for the graft material in an appropriate fashion.
  3. Bone graft material is inserted (socket preservation) or placed onto (ridge augmentation) the site and covered with a protective barrier material or membrane.
  4. Gum tissue is sutured closed.

What is the healing time for the bone grafting procedure?
Healing time is usually 4-6 months.  During this time, Drs. Horsley and Walker will check on the success of the bone graft by performing radiographs (x-rays) to examine the graft site and make sure that it is healing properly.  Once the dentist is satisfied with the procedure, and the site is totally healed, your dentist will proceed to place your dental implant.

What are the risks of bone grafting?
The biggest risk of a bone graft is the possibility that it will fail.  Although bone grafting is a common procedure, there are guidelines in picking a good candidate. A healthy and compliant dental patient greatly reduces the likelihood of bone graft failure.  Failure of bone grafts depend on many factors, including the overall health of the patient, medications the patient is taking or may have taken, the health of the patient’s hard and soft tissue, and the patient’s home care. If a patient smokes the failure rate is 2.5 times greater than for a patient who does not smoke.  As you can see, selecting a proper bone graft candidate greatly reduces the number of failures, and it’s the most important step in getting long-term results.

Despite selecting a proper bone graft patient, there are some complications that can arise after surgery.  Infections can occur soon after a graft is placed, this can cause immediate failure.  Patient compliance becomes a top priority after a graft is placed. Patients must follow through with pre-, and post-operative instructions, including taking their prescribed medications.   A failed graft can be removed, and once the area has healed, it can be replaced with a new graft if the patient still desires an implant at that site.

You may learn more about bone grafting in Farmersville and Van Alstyne, Texas, by calling us at 469-812-7100 to schedule a visit with our dentists soon.