Bone Grafting

Major & Minor Bone Grafting

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed (shrinks away). This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants in the proposed site. In these situations, most patients are not candidates for placement of dental implants unless bone grafting is performed to rebuild the bony foundation.

Today we have the ability to graft and grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to place implants in the optimal position in order to restore optimal to functionality and aesthetic appearance.

Minor and Major Bone Grafting

MINOR BONE GRAFTING

Minor bone grafting can repair proposed implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). In most cases tissue bank derived bone is used. This saves patients having to heal a second surgical wound where the bone was harvested to be used for grafting. The bone graft is most often placed to restore lost bone width.  It can also be placed to rebuild bone height, although the ability to grow bone vertically is much less predictable.

In the majority of cases a membrane will be placed to cover and protect the graft during the healing process. This optimizes the quantity of bone that will be regenerated at the site. In the majority of cases the membrane is resorbable. In some cases non-resorbable membranes are placed that are later removed.

Sinus bone grafts (see Sinus Lift) are also performed to replace bone in the posterior upper jaw. The maxillary sinus is positioned above your upper psoterior teeth. The sinuses are air spaces within the bone. They are like empty rooms. When implants need to be placed in this region there is sometimes limited bone height in the area due to the presence of the sinus cavity.

A solution to this problem is a sinus lift bone graft. This is performed by creating a lateral window “in to” the sinus above where the missing tooth is located. The sinus membrane is then lifted off the floor of the sinus to create a space for the bone graft to be placed. The bone graft is deposited in the floor of the sinus to regenerate bone height in the area. The lateral window is covered by a resorbable membrane and the wound sutured closed.

MAJOR BONE GRAFTING

Major bone grafts are typically performed to repair major defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different sites depending on the size of the defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.