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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 section 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 – Synthetic bone (manmade) can be created in the laboratory and used in the bone grafting procedure.  Bone can also be obtained from a bone bank (cadaver bone).

  • Xenograft – This is the implantation of bovine (cow) bone. A xenograft is perfectly safe and has been used successfully; ample bone can be obtained, and a secondary donor site is not necessary.

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 – Ridges in the bone can occur due to trauma, injury, birth defects, or severe periodontal disease.  The bone graft is used to fill in the ridge and make the jawbone a uniform shape.

Nerve repositioning - If the inferior alveolar nerve requires movement to allow for the placement of implants, a bone grafting procedure may be required.  The inferior alveolar nerve allows feeling and sensation in the lower chin and lip.

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.

If you have any questions about bone grafting, please ask your dentist.

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I WISH I COULD GIVE YOU 10 STARS!!!!
Omg!!! SOOOOO happy I found you!!!
I've had these 4 veneers on my front teeth for about 5 years, put on, again, and again and again, after pop offs and cracks and breaks, and several thousands of dollars, by another Santee dentist's office (won't mention who).
After about 4 years of miraculously no problems, I felt a familiar crunch while biting into a fish taco... I was so upset, I just froze staring at this tiny piece of porcelain in my hand. The tears starting welling up as I was reminded of the nightmares I often have of this exact thing happening on a date, or during a job interview... I knew I wouldn't be able to enjoy the rest of my mom's birthday lunch w my daughters, and luckily, I decided to drive myself. I held back the tears, apologized and asked that they wrap up the rest of my meal and I'll see you at home, and ran to my car, wanting to just vomit.... I'm not too vain, am I?
Not just for vanities sake, but the thought of coming up with another 2 grand to fix this, again, was taunting me! My head was spinning. I felt like I had been kicked in the jaw - literally.
First thing I did, after having a few glasses of wine to calm down, was do a search on Yelp. Dr. Fossett was the first to come up -- but still wanted to give my old office a chance, seeing as especially how They WERE THE ONES WHO PUT THE ORIGINALS ON. But, they offered no rest for my weary soul -- no discounts, no deals and no financing. And a replacement will cost @2000!!
I called Dr. Fossetts office next and was enchanted by Robyn, who understood my plight and offered all the help she could; gave me a rough estimate on cost (final cost was LESS than what she quoted!), and applied for Care Credit for me over the phone.
I could go on and on about how my appointment went -- didn't even have to sit or wait, was brought back for a consultation immediately. Not expecting to have everything even started the same day, the assistant and Dr. Dave came back in two minutes and said, let's get started!
Not more than 30 minutes later, I looked in the mirror to the most gorgeous "Temporary" veneer I have ever seen!! I mean, I'd be happy w this for years! The last office would spackle on this horrible looking crap that had no esthetically pleasing value at all!! THIS is a premier job!
And I'm a chronic perfectionist! Especially when it comes to my looks (hair, teeth, ect).
SO IF IM HAPPY, YOU BETTER KNOW THE JOB WAS STELLAR!!!
Thank you Dr. Fossett and staff-- THANK YOU!!!

Vanessa M.

Yesterday was my first visit to this wonderful Dental office. I haven't felt more welcome and comfortable in a Dental facility since I was 19... Now 31 years young. I grew up, going to a father/son dental group and Dr. David and Dr. Douglas Fossett had the same family centered vibe and conservative but smart dental care I've been searching for! As a Registered Nurse, quality care and patient centered care is the core of my own practice. Dr. David and Dr. Douglas exemplify this to a tee! I've finally found my go to family Dental office. I feel like a weight has been lifted off my shoulders after getting a second option from these very well informed Dentists!

Haylee R.

Great office!!! From the moment I walked in I felt very welcomed by the staff. I'm always nervous when going to the dentist no matter how many times I go, however after my visit to Dr. Fossett's office I felt much more relaxed and at ease. They did everything they could to make me comfortable. I felt the staff was very knowledgeable and answered any questions I had. The assistants are top notch . The smiles , kind hearts and exceptional service will keep me coming back. Thank you to the office for a positive experience.

Rachel Y.

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