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Bone Grafting for Dental Implants

What is a bone graft?

A bone graft is a method used to increase the amount of bone in a given area of the mouth to prepare that area for dental implant placement.  Bone grafts can be used to increase the width and/or height of your existing bone to optimize the site for implant placement.


What happens to the jaw bone after tooth extraction, and how is this important for implants?

After tooth extraction, the jaw bone always resorbs (decreases) in the area.  The only natural purpose of the bone around the teeth is to support the teeth, so after tooth extraction, the body naturally decreases the bone in the area.  This can create a problem for implant placement.


How do you determine if I have enough bone for implant placement?

A 3-dimensional CT scan will usually be taken to evaluate your potential implant site for enough volume of bone.  See link below for information on CT scans at Louisiana OIS.

Are bone grafts always required for implant placement?

No.  Many patients have enough bone for implant placement without undergoing a bone graft.


Why might I need a bone graft for my implant?

An implant must be placed into bone.  Bone grafts are used when your existing bone is not thick or tall enough to support an appropriately-sized implant.  If the CT scan reveals inadequate bone for implant placement, you will require bone grafting to support the implant.  Placing an implant into bone that is too thin or into bone that does not allow proper positioning of the implant can compromise the final result of your tooth replacement.

What are my options for anesthesia/sedation with bone grafting?

Please refer to the “anesthesia options” section of the website for extensive information regarding this topic (link below).

What forms of grafts are there?

Grafts generally come in 2 different varieties:  particulate or block. A particulate graft is like a coarse bone powder which can be shaped as needed.  A block graft is like a cube or prism of bone which is attached to your existing bone.


What is a sinus lift, and why might I need one?

Please see the sinus lift section of the website for information about sinus lifts.

Where does the bone for bone grafts come from?

There are 3 possible sources for bone graft material: bone from an animal (usually bovine), bone from a human cadaver, or bone harvested from yourself.  There are different situations where each type can be work better, and I will discuss any planned bone graft and rationale for choice before your procedure.


When are bone grafts performed?

Bone grafts may be performed at the time of tooth extraction, before implant placement, or at the same time with implant placement. Sometimes bone grafts are performed before and during implant placement, but this is rare.  If you need a bone graft, the timing will be determined by your individual situation. This will be thoroughly explained to you during your consultation visit.


Should I have a bone graft after my tooth extraction?

If there is any chance you may be interested in future dental implant placement into the site after the extraction, a bone graft is usually recommended at the time of tooth extraction.  Dental implants require a certain amount of bone at the site to be placed properly and predictably.  Bone grafting at the time of extraction can help ensure there is enough bone present in the future for implant placement.  


How long do bone grafts take to heal?

In general, bone grafts take 4-6 months to heal before an implant may be placed into them.  If the graft is able to be performed at the same time as implant placement, the graft and the implant can heal together which decreases total treatment time.


What are the risks of bone grafting?

In general, the most important risk to know about related to bone grafting is graft failure.  Unfortunately, bone grafts can become infected and have to be removed. This is very rare.


Does smoking affect bone graft healing?

Smoking decreases the success rate of bone grafts significantly.  The harmful effects of smoking on the mouth are numerous and last up to 6 weeks after the last cigarette/cigar is used.  Smoking within 6 weeks before bone grafting or within 6 months after the bone graft places you at increased risk for infection and graft failure requiring removal of the graft.


Is there a risk of transmission of infection from bone grafts?  

All bone graft material is sterilized prior to use and there has never been a proven case of transmission of an infectious disease from a oral bone graft.  


What special instructions do I need to follow after my bone graft?

There are several things you can do to to help prevent your graft from failing.  You will be given these written instructions after your procedure. Most bone grafts are placed in the form of small particles which need to stay still in order to heal.  This means you should maintain a soft diet only for the first 4 days after your graft.  You should also avoid chewing in the area where the graft was performed for at least 4 weeks after the graft.  You will be prescribed antibiotics as well as an antibiotic mouth rinse after your bone graft which you should take as directed until finished. Finally, avoid smoking.  Please see the post operative instructions for a bone graft for more instructions.

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