Bone Augmentation, often referred to as “bone grafting”, is a procedure to replace atrophied or missing bone in the jaw. Bone atrophy or bone loss can be caused because a tooth or multiple teeth are missing causing the bone to dissolve overtime. The body will naturally re-contour the bone in the jaw if there is not a tooth root or implant to maintain the bone level. Bone grafting is usually used in conjunction with implant placement. Implants have the best the best chance of success when surrounded by thick, healthy bone. There are a variety of ways to replace lost bone. Below you can read about different examples of bone replacement therapies.
Particulate Bone Grafting
A particulate graft consists of small bone particles place strategically around a tooth site. Particulate grafting is usually for a small single tooth area in preparation for a single implant placement. Particulate grafting can be done before or during implant placement. It is often completed when an extraction is done and an implant is placed at the same time. The particulate bone is placed in the voided area around the implant for optimal healing of an implant. The time of placement is discussed between the patient and the doctor and is determined based on the patient’s individual needs. Particulate graft materials come in a variety of synthetic and human bone substitutes. Patients may discuss the different bone augmentation sources and choose the most desired treatment based on their body and beliefs. Bone augmentation may also be grafted directly from the individual patient and milled to the correct particle size and placed where the bone grafting is needed, keeping the graft completely autogenous to the patient.
Block Bone Grafting
A block graft can be harvested directly from the patient, or it can be a human or bone substitute. The block is ordered or harvested at the size of the needed replacement. The block is tacked into place with a fixation screw or tack and left to heal for a period of some months until the patient’s body accepts the graft and in becomes natural bone to the patient’s body. After the healing phase is complete the area is ready for implant placement.
The human body needs to have proper maintenance in order to stay healthy. As most people know the muscles start to atrophy when they are not being used, the bones begin to do the same thing if a tooth has been extracted and a new tooth is not added to the mouth. The act of biting is a way to exercise the bone and will help it maintain its size.
Lateral Bone Loss after Tooth Extraction
Each time you bite down, you are keeping your jawbone healthy. When a tooth is extracted, the biting force no longer presses in this area, which causes the jaw bone to reabsorb itself. Lateral bone loss can end up with a 60% loss within the first year following extraction. Bone loss will continue to deteriorate without a dental implant. The bone loss can eventually get to a point where patients will need several bone grafts to strengthen the area to begin the dental implant process.
Sinus Atrophy After Extraction
When a tooth is extracted in the upper jaw, it can start to impact the jaw bone surrounding the area near your sinus. The sinus bone can start to absorb the bone, which changes air flow into the nasal passages. Due to the close proximity of nasal passages to the jawbone, the dental implant placement process can be particularly challenging for some patients. Read more about the sinus augmentation process here.
Multiple Tooth Bone Loss – Lower Posterior
When one tooth is extracted, it leaves other teeth vulnerable to decay. It is not uncommon to have multiple teeth extracted in the same region, which can lead to excessive bone loss in the lower region of the jaw. When the bone loss increases, the nerve will start to move closer to the top of the ridge. The nerve can cause problems with dental implants, and can make it particularly challenging for the healing process.
Full Arch Bone Loss
Patients with several missing teeth in the arch can deal with significant bone loss. When the roots are missing, the jawbone doesn’t have proper support and begins to deteriorate. Bridges may look aesthetically appealing, but they often fail as the jaw dissolves over time. Patients seeking full arch dental implants need to have several bone grafts. Bone arch cases are particularly challenging because the bone material may not be strong enough to support the titanium screws that need to be inserted into the bone.