Bone grafting for dental implants isn’t necessary for every case. Implant placement won’t be successful unless there’s strong enough existing bone in your jaw. Bone grafts increase the amount of bone to give you a foundation for the best possible implant outcome.
If you need bone grafting, you should understand how it works and the timeline you can expect. Here’s our guide to the dental bone graft procedure. At With U Dental, we aim to streamline the process to get you a new smile as soon as possible, so get in touch for a personalised timeline!
What is Bone Grafting?
Bone grafting is a surgical procedure used to repair or rebuild bones. When bone loss happens from tooth loss, trauma, or gum disease, the remaining bone may not be strong enough to support implants.
Around 50% of single dental implant candidates will need bone grafting before their implants can be placed. This is because the precise site of a single dental implant must match the location of the missing tooth. On the other hand, if you’re considering All-on-4 implants, your dentist can choose the best place (with more bone) for each implant, so you may not need bone grafting for All-on-4 implants.
A bone graft helps regenerate and stimulate the formation of new bone tissue, giving you a stable foundation for the implant. Bone grafting can use your bone or materials from other sources, including human, animal, or synthetic options.
Types of Bone Grafts
There are four different types of bone grafts typically used for dental implants. The selected option depends on your health and what’s available.
Autografts
Autografts use bone harvested from the patient’s own body, often from larger bones like the hip. This method is usually preferred because it reduces the risk of rejection or infection. However, it means you have to undergo an extra surgery to harvest the bone before you can have your bone graft, which can make the whole process take a lot longer.
Allografts
Allografts are made of bone sourced from human donors. The bone is processed and sterilised before being used. The advantage of allografts is that they eliminate the need for a second surgery, so the procedure is less invasive overall. This option is widely used and considered very safe, with a low risk of immune response.
Xenografts
Xenografts use bone from animals, most commonly cows or pigs. The animal bone is thoroughly cleaned and treated to avoid any risk of disease transmission. Xenografts don’t stimulate bone growth directly, but they act as a scaffold for the patient’s natural bone to grow. These bone grafts are quite widely used.
Alloplasts
Alloplasts are synthetic bone substitutes made from materials like calcium phosphate or hydroxyapatite. These materials mimic the structure of natural bone and are biocompatible, meaning they won’t cause an immune reaction. Alloplasts don’t stimulate new bone growth but provide a stable framework for the patient’s own bone to grow onto.
Why Would You Need a Bone Graft?
You would need a bone graft when your jawbone lacks the necessary density or volume to maintain dental health, or in most cases, to support a dental implant. One common reason is bone loss from missing teeth. When teeth are absent for a long time, the jawbone begins to shrink because it no longer gets the stimulation it needs from chewing.
Another reason is gum disease (periodontitis), which can cause severe bone deterioration around the teeth. Bone grafts also help in cases where trauma and injury have damaged the jawbone. A graft can restore its structure and strength for dental implants or other treatments.
Symptoms Showing You Need a Dental Bone Graft
- Loose teeth
- Changes in jaw shape
- Gum recession
- Pain in the jaw
- Difficulty chewing
The Bone Grafting Procedure
Bone grafting for dental implants needs to happen before you can have your implant surgery. Here’s how the process works:
Pre-Operative Assessment
Before a bone grafting procedure, you’ll undergo a thorough pre-operative assessment. This evaluation includes a detailed review of your dental and medical history, including any medications or health conditions that might impact your healing.
Your dentist will use imaging tests like X-rays or 3D scans of the jaw to assess bone loss and determine that there’s a need for a graft. Your dentist will also evaluate your overall oral health, including the presence of gum disease, which can affect the success of the procedure.
Surgical Techniques
- Socket Preservation: By placing a bone graft or substitute into the empty socket, this method helps prevent bone loss, which often happens following the extraction of a tooth.
- Ridge Augmentation: Used to rebuild the jawbone’s height and width when it has become too thin or has resorbed after tooth loss. This process involves adding bone graft material to the affected area.
- Sinus Lift: Often necessary when placing implants in the upper jaw, especially if the bone between the sinus and the oral cavity is too thin. The sinus membrane is gently lifted, and bone graft material is added to create enough height in the bone to securely anchor an implant.
- Onlay Grafting: Onlay grafting is used when there’s a lot of bone loss, and a large volume of bone is needed to restore the area. Bone grafts are placed directly on top of the deficient bone, building up the area until it can support a dental implant.
- Incision and Placement of Graft Material: Incisions are usually made in the keratinised tissue, and a tension-free closure is achieved with vertical incisions away from the grafting site. The graft material is placed in the desired area, serving as a scaffold for new bone growth.
- Membranes for Protection and Suturing: Barrier membranes are often used to protect the graft and prevent soft tissue from growing into the site, which could compromise healing. Membranes can be either resorbable or non-resorbable, depending on the needs of the patient. Sutures are used to close the incision, securing the membrane and graft in place.
Post-Operative Care
After the surgery, you’ll be advised to avoid disturbing the surgical site, including avoiding vigorous rinsing or touching the area. Swelling and bruising are common and can be managed with cold compresses.
It’s important to eat soft foods and stay hydrated while avoiding alcohol and smoking, because these can impair healing. Follow-up visits will monitor the progress, and any pain can typically be managed with over-the-counter medication.
Healing and Integration
After a dental bone graft, healing happens in several stages, often taking 3 to 6 months to complete. In the first few days, your body forms a blood clot at the graft site, which protects the graft.
Over the next few weeks, new bone-forming cells (osteoblasts) begin to form on the graft material. This process, known as osseointegration, can take 3 months or more depending on factors like your overall health, the type of graft used, and the extent of bone loss. The end result and overall success of bone grafting dental procedures depend on how well you look after your oral health in these months.
Success Rates and Complications
Dental bone grafting has a high success rate – from 95 to 98% – especially when the patient has good general and oral health. However, complications and failures can happen, although they are rare.
Factors Influencing Success
- Your Overall Health: Conditions like diabetes or autoimmune diseases can make it harder to heal. Older patients also tend to be more likely to have complications.
- Bone Quality at the Graft Site: Enough bone structure is needed for there to be no complications in the bone you’re harvesting from.
- Type of Bone Graft Material Used: Using your own bone has the highest success rate. This diminishes slightly with other types of material.
- Your Own Aftercare: Smoking is the fastest way to ruin a bone graft, as it invites infection. Good oral hygiene and following your dentist’s instructions closely are of huge importance for a successful bone graft.
Common Complications
- Infection: Infection is one of the most common complications and is often caused by poor dental hygiene while you’re healing. It can set back your healing and make more dental treatments necessary before you can have dental implants.
- Graft Failure: In this case, the new bone doesn’t integrate properly with the surrounding tissue. This could result in the need for a new graft, and in rare cases, might lead to nerve damage.
- Sinus Issues: If the procedure involves the upper jaw, there’s a chance that the sinuses could be impacted, leading to sinus infections.
- Insufficient Bone Growth: It’s important to understand that even with a bone graft, there’s no guarantee that you’ll end up growing enough bone to support dental implants.
If you have any further questions or concerns about bone grafting and dental implants, contact our friendly team at With U Dental.
Bone Graft for Dental Implant | FAQs
How much does a bone graft cost?
In Australia, the cost of a bone graft for dental implants can vary depending on several factors, including the type of graft material used, the complexity of the procedure, and the location of the clinic. Here’s a general breakdown:
- Basic bone grafting procedures start at approximately $400 to $500 per site for smaller or less complex cases
- More complex procedures, like those requiring autografts (using the patient’s own bone), can cost $1,000 or more due to the extra surgery involved
These figures reflect the general costs across Australian dental clinics, though prices can fluctuate based on individual circumstances and treatment plans. It’s important to consult with a dental professional to receive a detailed estimate tailored to your specific needs.
Are there any alternatives to bone grafting?
For patients with minor bone loss, mini dental implants could be used as an alternative to bone grafting. In severe cases, the patient may need to reconsider dental implants as a course of action. It’s important to discuss alternative options with your dentist to determine the best option for you.
