Bone Grafting

Major & Minor Bone Grafting

Missing teeth over a period of time can cause your jaw bone to atrophy, or resorb. This often results in poor quality and quantity of bone suitable for the placement of dental implants as well as long term shifting of remaining teeth and changes to facial structure. Most patients, in these situations, are not candidates for dental implants.

Fortunately, today we have the ability to grow bone where it is needed. This not only gives us the opportunity to place implants of proper length and width, but it also gives us a chance to restore functionality and aesthetic appearance.

Major Bone Grafting

Bone grafting can repair dental 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). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum to protect the bone graft, as well as encourage bone regeneration. This is called guided bone regeneration, or guided tissue regeneration.

Major bone grafts are typically performed to repair 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 areas depending on the size needed. 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.

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The entire staff both in Tarentum Shadyside we're terrific. Informative, kind, patient, friendly; especially this morning when the receptionist had a very difficult patient's parent. She remained kind and unmoved by her rude behavior treating her with extreme kindness when the mother was being anything but to her. The medical assistant, nurse anesthetist and entire rest of the staff were caring and made my procedure more Bearable. Thank you everyone.

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About Bone Grafting

What is Bone Grafting?

Over a period of time, the jaw bone associated with missing teeth atrophies and is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for the placement of dental implants. In these situations, most patients are not candidates for the placement of dental implants.

With bone grafting we now have the opportunity to not only replace bone where it is missing, but we also have the ability to promote new bone growth in that location. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.

Types of Bone Grafts

Autogenous Bone Grafts:
Autogenous bone grafts, or autografts, are sourced from the patient’s own bone, often from areas like the chin, jaw, leg, hip, or skull. They contain living cellular elements that promote bone growth and reduce the risk of rejection. However, obtaining the graft requires a separate surgical procedure.

Allogenic Bone:
Allogenic bone, or allograft, is harvested from cadavers and processed to remove water. It acts as a scaffold for surrounding bone growth but cannot generate new bone independently.

Xenogenic Bone:
Xenogenic bone is sourced from non-human species, typically cows, and processed to prevent rejection. Like allogenic grafts, it acts as a scaffold for bone growth but lacks inherent bone-forming properties.

Bone Graft Substitutes

As a substitute to using real bone many synthetic materials are available as safe and proven alternatives, including:

Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA)

This product is processed allograft bone, containing collagen, proteins, and growth factors that are extracted from the allograft bone. It is available in the form of powder, putty, chips, or as a gel that can be injected through a syringe.

Graft Composites

Graft composites consist of other bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include: collagen/ceramic composite, which closely resembles the composition of natural bone, DBM combined with bone marrow cells, which aid in the growth of new bone, or a collagen/ceramic/autograft composite.

Bone Morphogenetic Proteins

Bone morphogenetic proteins (BMPs) are proteins naturally produced in the body that promote and regulate bone formation and healing.

Synthetic materials also have the advantage of not requiring a second procedure to harvest bone, reducing risk and pain. Each bone grafting option has its own risks and benefits. Dr. Eichner, Dr. Smiga, Dr. Davies or Dr. Robertson will determine which type of bone graft material best suited to your particular needs.

Reasons for Jaw Bone Loss and Deterioration

The following are the most common causes for jaw bone deterioration and loss that may require a bone grafting procedure:

  1. Tooth Extractions: When a tooth is removed without replacement, jaw bone deterioration can occur due to lack of stimulation. This process, called resorption, varies in rate and extent among individuals but typically accelerates within the first eighteen months post-extraction and continues gradually thereafter.
  2. Periodontal Disease: Periodontal diseases are ongoing gum infections that gradually damage tooth support structures. Plaque-induced inflammation is the primary cause, leading to conditions like gingivitis and, if untreated, progressing to periodontitis, which can result in tooth loss due to gum tissue and bone deterioration.
  3. Dentures/Bridgework: Unanchored dentures placed on the gum line don’t stimulate the underlying bone, leading to resorption over time. Similarly, portions of bridgework lacking direct stimulation can cause bone loss. Anchored dentures and proper care can mitigate these effects.
  4. Trauma: Tooth and jaw trauma, including injuries resulting in tooth loss or fractures, can halt bone stimulation, leading to bone loss. Bone grafting procedures can reverse this effect, restoring function and promoting new bone growth.
  5. Misalignment: Misalignment can lead to unopposed teeth, causing over-eruption and bone deterioration. Abnormal forces on teeth from issues like TMJ problems or wear-and-tear can also contribute to bone loss.
  6. Osteomyelitis: This bacterial infection in the jaw bone can cause inflammation and reduced blood supply, necessitating antibiotics and bone removal. Bone grafting may be needed to restore lost bone function and growth.
  7. Tumors: Benign or malignant tumors may require jaw bone removal, often necessitating reconstructive bone grafting to restore normal function.
  8. Developmental Deformities: Conditions characterized by missing facial bones or teeth may benefit from bone graft procedures to restore function and growth.
  9. Sinus Deficiencies: Tooth removal in the upper jaw can lead to sinus enlargement and insufficient bone for dental implants. A sinus lift procedure can address this issue by treating enlarged sinuses.

The Importance of Teeth for Jaw Bone Health

When one or more teeth are missing it can lead to bone loss at the site of the gap. This can develop into additional problems, both with your appearance and your overall health. You may experience pain, problems with your remaining teeth, altered facial appearance, and eventually even the inability to speak and/or eat normally.

In the same way that muscles are maintained through exercise, bone tissue is maintained by use. Natural teeth are embedded in the jaw bone and stimulate the jaw bone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jaw bone that anchors the teeth into the mouth, no longer receives the necessary stimulation it needs and begins to break down, or resorb. The body no longer uses or “needs” the jaw bone, so it .

Potential Consequences of Tooth and Jaw bone Loss

  • Problems with remaining teeth, including misalignment, drifting, loosening, and loss
  • Collapsed facial profile
  • Limited lip support
  • Skin wrinkling around the mouth
  • Distortion of other facial features
  • Jaw TMJ or temporomandibular joint) pain, facial pain, and headaches
  • Difficulty speaking and communicating
  • Inadequate nutrition as a result of the inability to chew properly and painlessly
  • Sinus expansion

Are You in Need of Oral & Maxillofacial Treatment?

You can trust Drs. Eichner, Smiga, Davies, Robertson and Hartman to provide you with outstanding care. Contact us to learn more about your treatment options.