Dental Bone Grafts in St George

At Red Hills Dental, bone grafting is usually performed in order to improve the long-term success of dental implants. In most instances, the success or failure of an implant can hinge on the height, depth, and width of the bone at the implant site. When the bone has receded or sustained damage like after a tooth extraction, the remaining bone is often inadequate to be used as a foundation for implant therapy.

Reasons for bone grafts

There are predictive factors that affect the bone volume and quality in the mouth:

• Periodontal/Gum Disease: Gum disease permanently damages the jaw bone that supports the teeth. As Gum disease progresses, more bone is permanently lost. The same bacteria involved with Gum disease can also cause bone loss around dental implants. 
• Tooth Extraction: When a tooth is removed, a very important supportive structure is removed as well…the Periodontal Ligament (PDL). The PDL contains cells that tell bone to grow, shrink, or maintain position. When a tooth is removed, the PDL is destroyed and the bone naturally collapses. Studies confirm that there is a 30% collapse of bone in the first 3 months following a tooth extraction. Furthermore, studies show that up to 60% of the bone surrounding the tooth socket is lost during the first three years. Loss of bone is called a “bone defect”. 
• Injuries and Infections: Injuries to the mouth and jaw can cause bone to recede as well. Injuries damage blood vessels that provide necessary nutrients to bone. When blood flow is disturbed, bone recedes or dies. Bone is the body’s biggest coward. Dental infections and abscesses are forms of injury that cause the same type of bone destruction to occur. While healing from a bone graft, injuries will also damage the graft much quicker and more severely than well-healed bone.
• Osteoporosis: Osteoporosis is a disease that lessens the density of bone and in severe cases can affect the quality of bone around implants.
• Diabetes: Diabetes affects the health and healing capacity of bone. While studies show that bone grafts can be very successful in people with diabetes, they also show that without proper care and preparation, implants will prematurely fail. For diabetics, the magic number is an HbA1c of 7 or lower.
• Medications: Many medications affect bone. No medication will spontaneously grow bone; however, some can have negative effects. Speak with Dr. Bergman and be open about all of the medications and supplements you are taking prior to bone grafting.
• Smoking: Smoking affects blood flow. Blood flow affects healing. Healing affects tissue response. Smoking masks the signs of gum disease and other deleterious. When you have a bone graft or implant procedure, be ready to stop smoking for a period of time…usually 2-6 weeks depending on the extent and complexity of the procedure. 
• Other: Of course there are other factors affecting the quality and quantity of bone.

Types of Bone Graft

Bone grafting is highly successful. Bone grafting can increase the height and/or width of the bone and fill in voids and defects. There are two basic ways that a bone graft can be classified:

Augmentation: An augmentation adds volume to existing bone. When the bone is too narrow, bone augmentation is performed to widen the bone. When a bone deformity exists, a bone augmentation is performed to fill in the defect. Bone augmentation can be shaped and defined for the desired outcome.

Preservation – Bone grafting is used to preserve existing bone. This is done following a tooth extraction, with periodontal defects, or with other invasive procedures.

Graft Materials

The following are the four different types of materials used for bone grafting:

1. Autogenous Bone Graft – Taken from your own body, autogenous bone is your bone. This material has your cells in it and is the most ideal material for grafting.
2. Allograft Bone Graft – Allograft bone is not your own bone. It is taken from a bone donor and sterilized. This material comes in second as the most ideal for grafting.
3. Xenograft – Xenograft is bone graft material from a different species of mammal that has been sterilized. The most common type is bovine, or cow bone. A xenograft is very effective and useful when a large area has to be grafted and you require a more durable placeholder for new bone to grow. Xenograft is often used in sinus grafting because of the long time it takes for the bone to grow in the sinus.
4. Synthetic – Synthetic grafting material can be resorbable or non-resorbable. Synthetic grafting is the poorest material to use for grafting. However, when no other option is available or desired, synthetic bone material remains. Advances are currently being explored and developed in order to make synthetic materials more desirable.

What to Expect

Dr. Bergman most commonly uses a combination of autogenous graft material and allograft material. A bone grafting procedure is the only way to build bone where volume is deficient. With materials used at Red Hills Dental, the bone fuses with the graft and new bone grows in the spaces around the graft material. Cells from your body gradually eat away at the graft material until all that remains is completely new bone created by your own body. The length of time it takes for you to grow bone into a defect depends on several factors, but 3-6 months is average. On occasion, a synthetic membrane may be used to cover the new bone. This membrane prevents soft tissue and bacterial invasion into the bone graft and encourages new bone growth. The surgery does not require an overnight stay, and you will be provided with comprehensive instructions for your post-operative care. Dr. Bergman will prescribe medications to help manage infection, discomfort, and swelling.