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JacksonvilleDentalImplants.com
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Oral Surgery
Bone Grafting

Periodontal disease is the leading cause of bone loss in the oral cavity, though there are others such as ill-fitting dentures and facial trauma.  The bone grafting procedure is an excellent way to replace lost bone tissue and encourage natural bone growth.  Bone grafting is a versatile and predictable procedure which fulfills a wide variety of functions.

A bone graft may be required to create a stable base for dental implant placement, to halt the progression of gum disease, or to make the smile appear more aesthetically pleasing.

There are several types of dental bone grafts.  The following are the most common:

  • Autogenous bone graft – In this type of graft the bone is removed from elsewhere in the body and implanted in the mouth.  Common donor sites for bone grafting include the iliac crest of the pelvis, the chin and the posterior third molar areas of the jaw.  If large amounts of bone need to be harvested, the hip or the shin bone (tibia) is generally used.
  • Allograft  is the transplantation of cells, tissues, or organs, to a recipient from a genetically non-identical donor of the same species. This bone is obtained from a bone bank (cadaver bone) but has been processed/sterilized to make it usable in recipients. 
  • Xenograft  A Xenograft is a graft from a different species, such as when animal tissue is grafted to help humans, most commonly bovine (cow) bone. A Xenograft is perfectly safe and does not require a secondary donor site. This material tends to be very dense and as such is very slow to resorb and replace with the recipient's own bone.  
  • Synthetic  Synthetic bone (manmade) can be created in the laboratory and used in the bone grafting procedures. Because synthetic grafts rarely resorb they are used more as a filler as opposed to a biologically active graft material to heal to dental implants.
  • Bone Morphogenetic Proteins  are growth factors made in a lab using recombinant technology. BMP induces bone formation in the same fashion as your own bones when a break occurs. BMP can be used by itself or in conjunction with other grafting materials and is a very predictible alternative. Due to it's cost, other types of grafting are often considered unless extreme predictibility is required. 

Reasons for bone grafting

There are a wide variety of reasons why bone grafting may be the best option for restoring the jaw bone.

Dental implants – Implants are the preferred replacement method for missing teeth because they restore full functionality to the mouth; however, implants need to be firmly anchored to the jawbone to be effective.  If the jawbone lacks the necessary quality or quantity of bone, bone grafting can strengthen and thicken the implant site.

Sinus lift – A sinus lift entails elevating the sinus membrane and grafting bone onto the sinus floor so that implants can be securely placed.

Ridge augmentation – Bone loss or atrophy in the jaws can occur due to trauma, extractions, injury, birth defects, or severe periodontal disease.  The bone graft is used to fill in the defect and make the jawbone a uniform shape.

Nerve repositioning - If the inferior alveolar nerve requires movement to allow for the placement of longer implants, a bone grafting procedure may be required to fill in the residual nerve canal space.  The inferior alveolar nerve supplies feeling and sensation to the lower chin and lip areas and often can prohibit the placement of dental implants in the posterior mandible when significant atrophy has occurred.

What does bone grafting treatment involve?

Bone grafting is a fairly simple procedure that can be performed under local anesthetic; however, if large amounts of bone area need to be grafted, general anesthetic may be required.

Initially, the grafting material needs to either be harvested or prepared for insertion.  A small incision is made in the gum tissue and then gently separated from the bone.  The bone grafting material is then placed at the affected site.

The bone regeneration process may be aided by:

  • Gum/bone tissue regeneration – A thin barrier (membrane) is placed below the gum line over the grafting material.  This barrier creates enough space for healthy tissue to grow and separates the faster growing gum tissue from the slower growing fibers.  This means that bone cells can migrate to the protected area and grow naturally.
  • Tissue stimulating proteins – Enamel matrix proteins occur during natural tooth development.  Emdogain is a matrix protein product which is usually placed on the affected site before the gum is sutured.  It mediates the formation of accellular cementum on the tooth which provides a foundation to allow periodontal attachment to occur.  Tissue stimulating proteins help create lost support in areas affected by periodontal defects.
  • Platelet-rich growth factors – A high platelet concentration liquid can be used to create a blood clot at the site of a wound.  It has recently been discovered that PRGF also stimulates bone growth – meaning a denser graft in a shorter time period.

The gum is sutured in place and a follow-up appointment will need to be made within 10 days to assess progress.  Bone grafting is a highly successful treatment and a good base for further periodontal restorations.


4100 Southpoint Dr E    |   Suite 5   |   Jacksonville, FL 32216   |   Phone: (904) 281-2225
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