Bone Grafting – Carmel Valley | Del Mar | San Diego
Major & Minor Bone Grafting
Bone loss in the jaw is not uncommon, particularly if you have lost one or more teeth for a significant period. Dr. Sidal sometimes recommends bone grafting before specific dental procedures. A bone graft is usually needed if you don’t have enough healthy jawbone to support a process such as dental implants.
What is bone grafting?
When there is insufficient bone for a procedure, bone grafting builds up or adds healthy bone to your jawbone. It’s an essential first step if you need dental implants and don’t have enough jawbone to support the titanium implants successfully. Dr. Sidal will examine your jawbone and take x-rays to determine if you need a bone graft before surgery.
The material for a bone graft can come from your own body or from a bone bank or tissue bank. Occasionally, synthetic bone may be used. During the bone grafting procedure, a small section of bone is placed where additional bone support is needed, prompting your body to grow new bone tissue and heal the area surrounding the graft.
What are common bone grafting materials?
While bone from your own body can be used for a graft, several sources of donor bone can be used.
These bone grafts are sometimes called autografts and are made from bone in another part of your body. It may be harvested from your chin, lower leg, hip, or skull. There is no chance of your body rejecting your own tissue, and it heals quickly.
Also called an allograft, this is bone taken from a cadaver. It is freeze-dried and used as a framework as your body grows new bone around it. Because allografts are dead bones, they can’t grow tissue on their own.
Xenogenic bone is derived from the bone of an animal such as a cow. These are dead bones and act as a scaffold for your body to grow new bone, much like allogeneic bone grafts. The bone is processed at high temperatures to minimize the chance of rejection.
Alternatives to bone grafts
There are occasions when using actual bone to build up the jawline and generate new bone growth isn’t practical or advisable. In these situations, Dr. Sidal may recommend one of the following alternatives:
- DBM/DFDBA – Demineralized Bone Matrix or Demineralized Freeze-Dried Bone Allograft. This is a combination of proteins, growth factors, and collagen extracted from the allograft.
- Graft Composites – Various combinations of bone graft materials and growth factors. These may include collagen, ceramic composites, and bone marrow.
- Bone Morphogenetic Proteins – BMPs are naturally occurring proteins that help promote healthy bone growth and healing.
For more detailed information about bone grafting materials, you can check out the About Bone Grafting page, where Dr. Sidal explains each option in greater detail.
Common dental bone graft procedures
Sometimes called ridge expansion, augmentation helps reverse the bone loss caused when a tooth has been missing for a long time. The bone graft material is placed, and the jawbone grows around it, establishing a solid foundation for any additional work. Ridge augmentation can add height and width if the jaw ridge has grown thin.
A sinus graft procedure adds bone to the thin wall of the upper jawbone between the jaw and the sinus passage. This provides a better foundation for implanting teeth in the upper jaw. There may not be enough bone in the upper jaw without a sinus lift for a stable implant.
The empty tooth socket may expand when a tooth is lost or extracted, causing the jawbone to deteriorate. Socket preservation bone grafts prevent reabsorption of the bone, preserving the jawbone for future implants or other dental work.
Why Would I Need Bone Grafting?
Any oral surgery or dental procedure requires the support of a healthy jawbone, particularly if you are replacing missing teeth via dental implants. If there is not enough bone or it is not strong enough, bone grafting can encourage the growth of new, healthy bone. It can also build up the area if more bone is needed. There are several common reasons why you might need bone grafting as part of your dental treatment plan.
If a tooth is removed and the socket is left empty, the jawbone deteriorates over time. Your natural teeth are part of a symbiotic relationship with the jawbone. Chewing, speaking, and biting stimulate the jawbone and keep it healthy. Without teeth, the bone deteriorates over time, becoming thinner, more porous, and fragile. The jawbone essentially wastes away.
Periodontal disease can lead to infection of the jawbone and loss of healthy tissue. The two most common forms of gum disease are periodontitis and gingivitis, both of which can lead to deterioration of the bone. This can lead to loose teeth and, eventually, tooth loss.
Dentures or Bridgework
Because dentures and dental bridges sit on top of the gums, they don’t directly stimulate the jawbone, causing it to deteriorate. Your dentures may become loose and slip or click when you eat, drink, or speak.
Sometimes the upper molars have to be removed, leading to reabsorption of the upper jawbone. Enlarged sinuses and a thinner, more delicate jawbone are often the results. A sinus lift builds up the bone and restores the sinus passage to a normal size.
A tooth that is broken or knocked out can lead to bone loss. This is common with facial trauma and injuries such as jaw fractures, genetic problems, or damage from an accident.
Misalignment leads to bone loss because an area of the jawbone is not adequately stimulated because your teeth are not meeting up properly. This may be because of a missing tooth, crooked teeth, normal wear and tear, or problems such as TMJ and teeth grinding.
A bacterial infection called osteomyelitis damages the jawbone, destroying the bone marrow. The infection causes inflammation and reduced blood flow to the area. The infected bone has to be removed, and bone grafts are used to restore the jaw to health.
Tumors, both benign and cancerous, can lead to severe jawbone damage. Sometimes all or part of the jawbone has to be removed. Bone grafting is part of the procedure to restore function and rebuild the facial contours.
Some syndromes or genetic disorders cause jaw deformities or even missing sections of the teeth, jaw, and facial bones.
For more information on why you may need a bone graft, please visit our Bone Loss & Deterioration page, where you’ll find more detailed information.