Doctors have been performing bone grafts for more than a century, with many innovations in material, technique, and design, and ever-increasing applications. Anywhere in the body where bone tissue is compromised might benefit from a bone graft, but grafts are especially necessary for people who want to replace a missing tooth with a dental implant. When a person’s tooth falls out or is extracted, the area of bone where the tooth once lived is slowly absorbed back into the body, no longer stimulated by the tooth root. When multiple teeth are missing, a substantial amount of bone could be missing; this is why many people with missing teeth have a sunken appearance in their lower face.
The body naturally produces and sheds bone cells regularly, with old or damaged bone cells dissolving and new, healthy bone tissue replacing them, keeping the bones strong, but the bones need exercise to stay vital. Without exercise, more cells are absorbed than produced, and the bone tissue is reabsorbed. This is what happens in the jaw when a tooth root is removed; without the exercise of supporting the root, the bone doesn’t need to be bone anymore. Because jawbone loss is inevitable when a tooth is lost, many dentists recommend placing a bone graft in the same procedure as a tooth extraction – a preventative sort of graft called a socket graft that prevents bone loss in preparation for future dental implants.
The best possible way to replace missing teeth is with dental implants, but dental implants, which are designed to be permanent, rely on substantial healthy bone to keep them in place. If a socket graft isn’t placed when your tooth is extracted, or if your tooth falls out on its own, your jawbone will begin to deteriorate without some sort of intervention. To generate enough available bone in the jaw to safely place dental implants, you may need dental bone grafts before you can get implants, allowing the bone time to heal around the grafting material for a few months before implant surgery.
A dental bone graft is an outpatient procedure that shouldn’t take more than a couple of hours. The dentist exposes the jawbone through an incision in the gums, placing graft material in the affected site before suturing the gum tissue back together. The graft material encourages osteoblast cells to create new bone; gradually, the body eliminates the graft material and replaces it with new, healthy bone cells that are ready to support your implant restorations. In some cases, a procedure called a sinus lift is included in the bone graft procedure. The sinus lift may be necessary if any of the upper molars are missing and the sinus has started to migrate into the gap left by the tooth. After the sinus is lifted, a bone graft is placed in the gap, normalizing the sinus while restoring the jaw.
In many cases, the material used in a dental bone graft will come from the patient’s own body, either harvested from the very back of the jaw or elsewhere in a separate surgical procedure. For patients who would prefer as few procedures as possible, donor bone is also an option. This could be from a human or animal cadaver, harvested and sterilized so it’s medically safe, or a synthetic material could be used. Each of these materials has its own pros and cons, and your dental team will review your options with you at every step as you plan your dental restorations.