Why dental bone grafting?

Bone grafting is often used 1. to prepare the jaw for dental implants, as dental implants need adequate amounts of strong, healthy jawbone to be safely placed. 2. to repair damage caused by periodontal disease or trauma.

Why pre-implant bone grafting?

The purpose of pre-implant bone grafting is to strengthen the bone present in the patient's jaw in order to create a solid enough base for the anchoring of implants. Indeed, the placement of dental implants requires a solid and healthy bone base, in adequate quantity.

How long does it take between a bone graft and the placement of a dental implant?

It is usually necessary to wait 4 to 6 months before the implant can be placed. Your dentist will perform a CT scan to check the amount of bone finally available.

Bone Graft

1. Why do a bone graft?

Dental bone grafts are performed to help prevent long-term health problems associated with

tooth loss: in the absence of a tooth for several months or years, without teeth, the alveolar bone (i.e. the bone around the tooth) is no longer subjected to any pressure; it gradually resorbs (loss of bone volume) and its quality deteriorate,
gum disease: periodontitis is one of the main causes of bone loss in the oral cavity (e.g. reconstitution of the alveolar ridge),

and to provide sufficient bone material to support dental implants (pre-implant bone grafting). A classic procedure is sinus lift, also called sinus filling or sinus lift, in your upper jaw where there is often little bone volume in the back teeth.

2. Which material is used in a dental bone graft?

There are different methods of bone augmentation:

Synthetic grafting with the addition of a biocompatible material containing calcium (hydroxyapatite) and growth factors. Gradually, natural bone replaces the material. It is important to note that despite the use of external bodies, this technique does not carry any risk of disease transmission.
Autogenic transplant with removal of bone from the patient (iliac or mandibular bone removal). This type of graft, although less frequent than synthetic grafting, allows the reconstruction of large bone deficits by ensuring rapid healing and very good resistance to infection. Biosynthetic particles are often added to fill the volumes perfectly.

The grafted bone is placed either in the form of small blocks or in the form of shred material.

Greffe-osseuse-biomateriau-Dentiste-Divo

3. What are the different types of bone grafts?

Two types of bone grafts can be performed: fillers or apposition grafts.

Filling grafts are performed
- at the level of the maxillary sinuses (sinus lift) to restore sufficient bone height allowing subsequent placement of the implant.
- during dental extraction for replacement by an implant. The alveolus is then filled right away to avoid bone loss during healing.
Apposition grafts are performed on the maxilla or on the mandible when the width of the bone crest is not sufficient to accommodate the future implant because of its diameter or inclination. The sample usually requires general anesthesia.

Sinus Lift

Apposition Bone Grafts

4. What is a sinus lift?

Sinus filling, also called sinus lift, is a type of bone grafting to increase the thickness of the bone in the upper premolars and molars in order to have the necessary amount of bone, usually to place a dental implant.

Your dentist will elevate the floor of the maxillary sinus, a cavity filled with air (see diagram 1) by detaching the sinus mucosa (Schneider's membrane). He will then fill the space between the membrane and the bone with a synthetic or natural graft.

[In a second phase, he will proceed with the dental implant surgery.

sinus-lift-soulevé-sinus-implant-dentiste-divonne

implant-sinus-lift-soulevé-sinus-dentiste-divonne

5. What are the temporary consequences of a bone graft and post-operative care?

The patient will present

generally moderate pain
limitation of mouth opening for a few days
facial edema, the extent and duration of which vary greatly from one individual to another;

Anti-inflammatory and pain-relieving treatment with analgesics allows to reduce swelling and pain.

To allow good healing, it is important to follow these tips:

have excellent oral hygiene
- mouthwashes the next day and until complete healing (5 to 8 days)
- brushing teeth and gums with an ultra-soft brush the next day
have a mixed and lukewarm or cold diet, like mash or compote, in the first 3 to 5 days. Avoid overly salty or acidic foods
quit smoking completely before and after the procedure
in the event of a sinus bone graft, large and violent blowing efforts should be avoided during the first weeks;

At the same time, antibiotics prevent infections.

6. How long to wait before placing an implant after a bone graft?

It is usually necessary to wait 4 to 6 months after the bone graft before being able to place the implant. We will perform a CT scan to check the bone volume finally available.

7. What causes dental bone loss?

Bone loss can have several causes, in particular

Loss of one or more teeth that are not replaced (bone resorption)
Periodontal disease (gingivitis and periodontitis): deterioration of bone density and degradation of the peri-radicular bone (around the root of the tooth).
Ageing: decrease in bone density, gum firmness and attachment to the bone and tooth, resulting in reduced stability of the teeth.
Trauma: e.g. fracture of the alveolar bone.
Bone deformity.

Dentists - Divonne-les-Bains