- Dental bone grafting is performed to improve the density and volume of the jawbone.
- Doctors perform bone grafting immediately after tooth extraction, in patients with untreated gum disease, and before dental implant surgery. It helps create a stable foundation for tooth restoration.
- The final cost of a bone graft depends on the size of the tissue needed, the material used, and the involvement of medical specialists.
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Should you invest in dental bone grafting before getting dental implants? Here's everything you need to know.
When are dental bone grafts necessary?
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Tooth bone grafting, or ridge augmentation, is necessary when the bone is too thin to support dentition or a restoration, such as an implant and crown. This can happen because of bone loss. The main risk factors are:
aging,
tooth loss,
genetic or developmental defects,
trauma or injury,
untreated periodontal disease, and
a worn-down alveolar ridge (e.g., due to ill-fitting dentures).
Therefore, tooth bone grafting is typically recommended in three situations:
Immediately 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, prepare a stable base for tooth restoration.
A bone graft for a tooth implant is the most common reason, as such restoration needs a solid foundation. At least 1mm of bone tissue 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 the dental implant process. On the other hand, it significantly increases the implant success rate. It is worth discussing zygoma implants with your dentist instead. This may allow you to avoid bone grafting.
Dental bone graft cost
The average price of dental bone grafting in the US is $600; however, the cost near you may range from $250 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.
Bone grafting procedures are among the most common additional costs when getting dental implants.
Dental bone grafting materials
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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, for example, a form of metal or plastic.
The bone graft material ultimately chosen is determined by the dentist performing the dental bone graft procedure. It depends on the situation in your mouth and on the resources available to achieve the best results.
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 a local injection. Generally, the dental bone grafting procedure can be split up into five stages.
Preparation
The first part is always a thorough medical history check and the composition of a treatment plan. You will need to visit the office to discuss which material will be used for the graft. It is an opportunity to ask any questions you may have. Then, it is time for action.
Anesthesia
You might have anesthesia administered before your primary procedure. A local injection or IV sedation is most commonly used. In case of dental anxiety, you may have to be put entirely under.
You will likely 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 obtain the bone if it is determined that it should be taken from your body. The graft itself should not cause any more discomfort than having a tooth pulled.
The tooth is then removed if an extraction was scheduled.
Graft insertion
An anesthesiologist will monitor your vital signs during the operation if you go with general anesthesia. Before placing the sourced or artificial bone, the area will be thoroughly cleaned.
The dental bone grafting surgery itself is a short, simple procedure. Your surgeon will make an incision in the gum tissue if no extraction is needed. He or she will then insert the grafting material into the socket.
Stitching
When the grafted material is in the alveolar bone, the surgeon will suture the wound and may apply a bandage. The space 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. There may be some numbness. You are likely able to return home the same day. Depending on whether you had general anesthesia, somebody might have to drive you, and you may have to take the day off work.
Overall, you will need about 4-6 months of healing time for dental bone grafting. 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, whether it came from your body.
It is vital to adhere closely to your dentist’s instructions at the time of dental bone graft 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 pain relievers to manage these issues. You are unlikely to get an antibiotic prescription or need other medications if you are not prone to infections. Get plenty of sleep and take it easy for a couple of days.
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 an appropriate amount of bone growth has occurred and 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 does not 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, those who chose an allograft, and those with severe infection before grafting are at particular risk.
The most common side effects are:
infection,
heavy bleeding,
blood clotting,
nerve damage,
gum recession, and
anesthesia-related complications.
Signs of a failed dental bone graft include drainage, swelling, bleeding, or pain lasting more than 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.
FAQ
How long does a dental bone graft procedure take?
Do you need a bone graft for a dental implant?
A bone graft before dental implant surgery is not always necessary; it is indicated only when bone loss is present. Nonetheless, studies show that more than half of implant placement procedures are preceded by grafting.
A bone graft for a tooth implant increases the volume of the jaw, making the base more stable. The rod can be inserted deeper, reducing the likelihood of failure.
Is bone graft necessary after tooth extraction?
A tooth extraction bone graft is performed when the extraction has caused significant damage. This could be because the tooth itself was large. It is also recommended that the roots be twisted to occupy as much jaw volume as possible.
Can you get dental implants with bone loss?
Yes, it is possible. However, in this case, bone grafting is necessary to increase bone volume. This creates a stable base in the bone structure 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 for a small quantity of soreness in the gums. You may not even need pain medications. 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 depends on the size of the graft, its location, and whether you will 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?
Risks of bone graft surgery are not too serious and, as long as you follow post-op instructions, are not likely.
Dental bone grafting complications primarily involve infections and nerve damage. The side effects of both may include loss of feeling in the mouth and reduced taste sensation.
An infection after a 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 checkups are advised for smokers and people with inconsistent oral hygiene. Prevention is key.
If you feel dental bone graft stitches coming out, schedule a consultation. You may also experience draining, swelling, and bleeding in such a case.
References
- Periodontal (Gum) Disease: Causes, Symptoms, and Treatments
- Bone Grafts For Implant Dentistry: The Basics
- Frequency of bone graft in implant surgery
- Alveolar Ridge Augmentation: Comparison of Two Socket Graft Materials in Implant Cases
- Bone grafts in dentistry
- Bone Grafting: Sourcing, Timing, Strategies, and Alternatives
- Nutritional Aspects of Bone Health and Fracture Healing
Eric Moryoussef, DDS
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.