Bone grafting is commonly performed by an oral and maxillofacial surgeon to replace or augment bone in areas of tooth loss. Bone grafting to the jaws and facial structures may be necessary in a wide variety of scenarios. The most common bone grafts are facial skeleton and jaw procedures. Other common procedures include tooth extraction site graft, bone graft reconstruction and for a sinus lift. Shrinkage of bone often occurs when a tooth is lost due to trauma, severe caries, or periodontal disease. Additionally, bone loss may have already occurred due to infection or pathology around a tooth. There are many artificial biocompatible bone substitutes available; however, the best material for a bone graft is your own bone, which most likely will come from your chin, the back part of your lower jaw or your hip bone. The hip is considered to be a better source because the hip bone has a lot of marrow, which contains bone-forming cells. There are also synthetic materials that can be used for bone grafting. Most bone grafts use a person's own bone, possibly in combination with other materials.
To place the removed bone in the recipient site, little holes are drilled in the existing bone to cause bleeding. This is done because blood provides cells that help the bone heal. The block of bone that was removed will be anchored in place with titanium screws. A mixture of the patient's bone marrow and some other bone-graft material will then be placed around the edges of bone block. Finally, a membrane is placed over the area and the incision closed.
The bone graft will take about 6 to 12 months to heal before dental implants can be placed. At that time, the titanium screws used to anchor the bone block in place will be removed before the implant is placed.
When a tooth is lost, both bone and gum tissue compete for the vacant space. The gum tissue generates more quickly than bone, subsequently occupying the space. With a membrane placement we can keep the gum tissue from invading the space, which will ideally give the bone sufficient time to regenerate. Bone regeneration is often used to rebuild the supporting structures around the teeth, which have been destroyed by periodontal disease. Bone surgery may be used to attempt to rebuild or reshape bone. Grafts of the patient's bone or artificial bone may be used, as well as special membranes.
When a tooth is extracted and an implant is to be placed (either simultaneously or in the future) it is always necessary to complete bone grafting within the residual sockets that are left behind after the roots of the tooth are removed. The shape of the tooth root is always different from the shape of a dental implant and hence there are always residual socket defects (holes) that must be filled in so that there can be excellent contact of the implant to the newly formed bone.