With sweet intake increasing in our diets these days, the dental problems are increasing as well, which may lead to tooth loss. Long gone are the days in which people had to wear dentures or bridges to compensate for tooth loss. Due to recent technological advancements, in many situations a dental implant can be done to compensate for the tooth loss. Dental implant is an outpatient surgery in which your damaged tooth is removed and a new artificial tooth is placed in the place of the damaged tooth. Though this seems like an easy process, but its not as simple as it seems, as dental implant surgery may require other process’s to take place as well for the final implant to take place. One such process is known as bone grafting.
What is bone grafting?
Bone grafting is done to maximize the result of the dental implant surgery and is only needed if the patient doesn’t have enough bone in their jaw to support the dental implant. This is because dental implantation requires that a metal post is placed in the patients jawbone and then the new tooth is placed on top of that post. So in order for this implant to be successful, dentists first need to make sure that there is enough bone, in the area where the implant is supposed to take place, so that later on it provides support and stability to the implant. Bone grafting may also be required if there is not enough bone in the jaw so that the implanted metal post is submerged in the bone.
Usually the requirement of bone for an implant is at least 1mm around the implant. Though this figure may increase to 2 to 3 mm, depending on where the implant is supposed to be place. For example, when the implant is supposed to be placed near a tooth or next to another implant than that requires more bone than usual. The bone has to completely envelope the implant, but caution has to be taken that the implant does not go so deep that it starts to disturb the other anatomic structures nearby, such as the nerve in the bottom jaw.
Bone graft procedure
Though the term bone grafting sounds daunting, it is actually a simple procedure with a few steps. Firstly, the dentist needs to evaluate the quality and quantity of the bone already in your jaw and taking X rays of the patients jaw can do this. Once this is done, the dentist will place a cut at the place where the bone graft has to take place, so as to create a flap of skin at that point. Now the jawbone has been exposed and the bone to be grafted is placed in this place and is covered with a protective membrane, which protects it against any germs in the mouth and as a result helps the healing process. Lastly, the flap of gum (which was cut at the start) is stitched back into place. Then starts the healing process and to keep a check on the bone graft and its height and width X rays are done. When the bone graft is fully healed, the implant process can start.
Different types of bone grafting materials
There are different types of bone graft type (materials) available and the dentist will check before hand to see which one is most suited for the patient.
- Autografts: One of the most successful types of bone graft is the Autograft. This involves taking bone from your own available bone (usually from the hip or mouth) and then grafting it into your jaw. Since this involves one’s own bone, it is the safest and most effective way as there is no risk of either a disease being passed on or rejection of the bone by the body. The downside to this is that two procedures are involved, one to take the bone out and then to graft it in the jaw, which may leave the patient quite sore and is also time consuming.
- Xenografts: This is another method and involves taking bone from an animal usually a cow. The bone taken is sterilized and also undergoes a procedure to make it biocompatible. The biggest advantage of using this is that there is only one procedure involved and once the animal bone is grafted, natural bone growth is encouraged and eventually the animal bone will be replaced with the patients own bone. Though this is a great way to get bone grafting done many people are put off with the idea of using animal bone.
- Allografts: It involes a procedure like organ donation, only in this case people donate bones which are then sterilized and tested. This procedure has the same advantages as Xenografts but the disadvantages vary in the sense that there is always a risk of disease transmission as well as of immunogenic reactions. Also healing from this type of bone is slower and it also weakens by 50%.
- Alloplastic grafts: These are grafts that are man made from synthetic materials, usually calcium phosphate, as it is similar to the natural bone. In addition to the advantages mentioned in the xenografts section, another advantage alloplastic grafts has over other grafts is that alloplastic grafts are available in different shapes and sizes and can also be custom made and hence a perfect fit can be made. Though there is always the risk that the body might reject the alloplastic graft. Another disadvantage is that alloplastic grafts are weakened by this whole procedure.
So as you can see there are many different types of grafts available, each having its own set of advantages and disadvantages. There is also a question of timing of the grafting, whether it should be done at the time of implant or some time before the implant. But these all are questions that only your dentist can answer for you after a check up and a detailed discussion with you and though this all seems scary right now but all this would be highly beneficial for you in the long run as it’s a one time job while dentures and bridges on the other hand require a lot more work on a regular basis.
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If you are only looking to enhance the look of our teeth you should read about teeth veneers article which is a complete guide on cosmetic dentistry.