A dental bone graft is a procedure that aims to augment the density and volume of the jawbone. It is a preparatory one, which enables the dentist to mount restorations. Grafting does, however, come with larger costs and a longer treatment period.
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If you are planning dental implants or an extraction, you might need grafting. Different materials can be used depending on the patient’s circumstances. Have a look at what the procedure looks like, the costs, and what the possible complications include.
When are teeth bone grafts necessary?
Tooth bone grafting is necessary when the bone is too thin to support dentition or a restoration, typically an implant. This can happen because of bone loss. The main causes are:
- missing teeth,
- genetic or developmental defects,
- untreated periodontal disease, and
- a worn-down alveolar ridge (e.g. due to an ill-fitting denture).
Therefore it is typically recommended in three situations:
- directly after tooth extraction: to prevent the bone from being reabsorbed by the body
- in patients with untreated gum disease: to increase the chances of keeping loose teeth, and
- before dental implantation: to prepare a stable base for tooth restoration.
A bone graft for a tooth implant is the most common reason. At least 1mm of bone is required for safe implantation. The patient will need 1.5mm if the implant is placed next to a tooth or even 3mm when mounted next to another implant.
Bone grafting is conducted in over half of the patients just before implant placement, sometimes on the same day. Most often, however, it is recommended that you leave 4-6 months between the surgical procedures. This allows the material to integrate with the bone for a stable base.
Tooth bone graft notably raises the final cost of dental implant process. On the other hand, it greatly increases implant success rate.
A close look at the dental bone graft cost
The average cost of dental bone grafting is $600. The prices range from $250 up to $1,100.
Final cost is dependent on:
- whether your dentist is a specialist,
- on the size of the needed tissue, and
- on what material is used.
If the bone is sourced from your body, you might have to pay for hospitalization twice.
The bone grafting procedure is one of the most common additional costs when it comes to getting dental implants.
You are going to invest a lot of money towards a dental implant. It makes sense to do everything possible to make sure the implant is successful. Bone grafts can do so.
Dental bone grafting materials
There are four types of grafting materials:
- autograft: from the patient’s own body, the most popular places are from the chin or leg,
- allograft: from a human donor, often from a licensed bone and tissue bank,
- xenograft: from animal bone, usually from horses,
- alloplast: from a non-biological material, typically a form of metal or plastic.
Which is ultimately chosen is decided by the dentist performing the dental bone graft procedures. It depends on the situation in your mouth as well as on what resources are available.
It is important to review the type of bone graft with the patient as they may have safety concerns or ethical or religious reasons for rejecting allografts or xenografts.
Dental bone grafting step-by-step
If an autogenous graft is used, it will likely be done by a specialist, not a general dentist, and will require general anesthesia, not just local injection. Generally, the dental bone grafting procedure can be split up into five stages.
The first step is always a thorough medical history check and composition of a treatment plan. You and your dentist will discuss what material is to be used for the graft. Then, it’s time for action.
You might have anesthesia administered before your primary procedure. A local injection or IV sedation are most commonly used. In case of dental anxiety, you may have to be completely put under.
It is likely that you will have to fast for some time before, especially if a deeper type of anesthetic is used. This can help prevent complications.
Extraction and/or bone sourcing
Your dentist will first source the bone if it is determined that it should come from your body. The graft itself should not cause any more discomfort than pulling a tooth.
The tooth is then removed, providing an extraction was scheduled.
An anesthesiologist will monitor your vital signs during the operation if you go with general anesthesia. Before placing the bone, the area will be thoroughly cleaned.
The dental bone grafting surgery itself is a short, simple procedure. Your surgeon will make an incision if there was no extraction. He or she will then insert the grafting material into the area.
When the grafted bone is in place, the surgeon will stitch up the wound and possibly apply a bandage. The hole will be closed up with pins, plates, wires, or cables. Sometimes a titanium screw or splint is necessary to hold the tissue together.
If the bone was sourced from your body, that area will be sewn back together as well.
What to expect after dental bone graft
Dental bone graft recovery is mild. You are likely to be able to return home the same day. Somebody might have to drive you, depending on whether you had general anesthesia.
Overall, you will need about 4-6 months of dental bone grafting healing time in total. The material and the jaw need time to merge and grow. This period might be even longer, especially if you have a history of substance addictions or an oral condition. It also depends on the site of bone sourcing, if it came from your body.
Autografts from the chin can be a very uncomfortable recovery.
It is vital to adhere closely to your dentist’s instructions at the time of dental bone grafts recovery in order to prevent failure or complications. Symptoms that might cause discomfort, but are perfectly normal include:
- gum or skin swelling,
- draining from the surgical site,
- slight bruising,
- minor bleeding,
- nausea from anesthesia,
- pain in the affected area.
Use a cold compress and OTC painkillers to manage these issues. Your dentist might also prescribe a blood thinner. This can prevent blood clots in the surgical site as well as source of the bone used for grafting.
Dental bone graft aftercare also includes consuming mainly soft foods while the mouth heals. Food high in calcium and vitamin D can help speed up recovery. Avoid smoking, excessive drinking, and mouthwash that contains alcohol.
After a few days or even weeks you can expect a follow-up visit, one that often includes X-rays. Those can confirm that your surgery was successful. You might also get stitches or staples removed at this time.
Signs of dental bone graft failure
A bone graft is considered failed if the material falls out due to a loose tooth or receded gums. You might feel some granules in your mouth for a few days after your surgery. This is not a cause for concern if it doesn’t happen consistently.
Failure of a bone graft is relatively rare as it is a low-risk procedure. Nonetheless, some complications are possible. Smokers, elders, patients with chronic medical conditions, and those who chose an allograft are at particular risk.
The most common side-effects are:
- heavy bleeding,
- blood clotting,
- nerve damage,
- gum recession, and
- anesthesia-related complications.
Signs of a failed dental bone graft include draining, swelling, bleeding, or pain that lasts longer 3-5 days. If you notice these, schedule a consultation. You will probably have an X-ray that can confirm that everything is as it should be.
How long does a dental bone graft procedure take?
Including the extraction, the whole procedure can take as little as 45 minutes. It might last longer if you go with a more complex type of anesthesia or if biological membranes need to be placed.
Do you need a bone graft for a dental implant?
A bone graft for a dental implant is not always compulsory, only in the presence of bone loss. Nonetheless, studies show that more than half of implant placement procedures are preceded by grafting.
A bone graft for a tooth implant makes the volume of the jaw larger, making the base more stable. The rod can be inserted deeper, making failure less likely.
Is bone graft necessary after tooth extraction?
A tooth extraction bone graft is performed when the removal caused a lot of damage. This could be due to the fact that the tooth itself was big. It is also recommended if the roots were twisted in a way that occupied much jaw volume.
Can you get dental implants with bone loss?
Yes, it is possible. But in this case, bone grafting is necessary to increase bone volume. This creates a stable base for the implant. If your jaw is too thin or brittle, your implant is more likely to fail. The dentist will make the final decision about whether you are a candidate.
Is bone grafting painful?
There is not much dental bone graft pain after the procedure except a little soreness in the gums. Dentists often compare the recovery to what you feel like after a tooth extraction.
No doctor will perform bone grafting without proper sedation, however. Sometimes a local injection or laughing gas is enough. This is dependent on the size of the graft, the location, and whether you are going to be harvesting an autograft.
If you suffer from dental anxiety, you might have a stronger form of anesthesia.
What are possible dental bone grafting complications?
Dental bone grafting complications are mainly all about infections and nerve damage. The latter happens very rarely. The side effects may include loss of feeling in the mouth and a lack of a sense of taste. An infection after dental bone graft is usually caused by the patient not following proper post-op instructions. Since the procedure is surgical, excellent oral hygiene is a must. Extra visits to the dentists are advised for people who struggle with this as well as smokers.
If you feel dental bone graft stitches coming out, a consultation is key. This may be accompanied by draining, swelling, and bleeding.
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