Bone Grafting

Dental Implants ยป Bone Grafting

Philip Friel Advanced Dentistry provide a bone grafting service to patients throughout Glasgow, Edinburgh and Cental Scotland.

Among the wide range of treatments on offer to ensureyour smile reflects your personality is bone grafting or reconstruction - a well-tested procedure that can improve the function and beauty of your teeth.Because it acts as an anchor, a sufficient amount of jawbone is necessary to ensure thelong-term stability of teeth or dental implants.

When bone loss occurs, we at Philip Friel Advanced Dentistry have the skills to remedy the problem.

Bone is essential to support the teeth in function in the mouth. The bone and the teeth similarly, function to support the overlying soft tissues of the peri oral region. When teeth are lost, the bone supporting the tooth is gradually lost, as is the support for the overlying soft tissue. In addition, the amount of bone remaining for tooth restoration, especially implant placement or restoration is diminished. Bone grafting uses bone substitutes to reform areas of lost bone, allowing the missing teeth to be replaced as naturally as possible. All bone substitutes act as a scaffold, allowing the body to replace the artificial bone with its own over time. The time taken for this total replacement varies depending on the type of material used. These bone substitutes can be…

1 Animal derived. These are the most widely used type of grafts. Most commonly, a bovine (cow) bone graft material is used together with a porcine (pig) collagen membrane. At Philip Friel Advanced Dentistry, we commonly use products supplied by Geistlich Biomaterials who produce Biooss (Bovine bone) and Bioguide (porcine collagen) products.

2 Human derived. Taken from the patient themselves during implant surgery. The required volume of bone and the position of this graft may make this procedure necessary, but more commonly, animal derived grafts can replace the bone lost as necessary for most treatments. In some countries, human donor bone is the material of choice but this is not used very commonly in the UK.

3 Totally artificial (laboratory made). Many patients elect to use such bone products for either religious or socio-ethical reasons.

What causes bone loss?

Accidents or inflammation of the gums and bone due to bacteria cancause bone loss. The height and thickness of the jawbone can also diminish after teeth have been removed.

When is bone reconstruction needed? This procedure is carried out under a number of circumstances:

  1. Before inserting dental implants if the existing bone is insufficient to ensure stable tooth anchoring
  2. In cases whereextensive bone damage has occurred
  3. To correct a bone defect at the back of the upper jaw, a procedureknown as sinus floor augmentation
  4. To repair bone that has been destroyedfollowing root resection or cyst removal

How is bone reconstructed?

Human bone has the ability to renew itself butin most cases it needs assistance. Philip’s supplier, Geistlich Biomaterials, has developed rigorously tested natural products, including a bone substitute that enhance the body’s regeneration processes extremely effectively and aid the healing process.

How will I feel after the surgery?

Some people may experiencediscomfort but there are quick and easy remedies to ease any tenderness.
Swelling can be treated with cold compresses.

If pain occurs, suitable painkillers will be prescribed.

During the first weeks after surgery avoid the area operated on when brushing your teeth and use an antibacterial mouthwash. After this, a special soft toothbrush can be used to clean the area around the wound.

Avoid coffee, alcohol and cigarettes for two to three days after surgery. This reduces therisk of bleeding and boosts the healing process. Heavy smoking and poor oral hygiene can adversely affect the outcome of the procedure It is vital you attend all check-ups with the clinical team even ifhealing is proceeding without problems.

What about the products used during bone reconstruction?

Philip Friel Advanced Dentistryensures the products used conform to the highest safety standards and are made under strictly controlled manufacturing procedures from the finest raw materials.

Independent institutions and state authorities regularly check Geistlich Biomaterials’ production processes and the company operates a documented quality assurance system.

How effective are Geistlich Biomaterials’ products?

These have been part of the standard therapy in the field of bone reconstruction for many years throughout the world. Many clinical studies have reported on the reliability of both products.

Regardless of the type of material used, the actual graft procedures are relatively similar and can be used to recreate bone using:

  • Guided Bone regeneration around implants – This procedure allows the width of a remaining bony ridge to be increased at the time of implant placement meaning that the final implant restoration has a very natural appearance and morphology.
  • Socket Preservation – This process involves packing the socket of an extracted tooth with bone graft material to maintain the bulk of bone in the area. This can be very useful for either future implant placement or when a bridge is the planned restoration for the area as it allows the natural ridge dimensions to be maintained.
  • Immediate implant placement – In some cases, when a tooth extracted, an implant can be placed immediately into the extraction socket. When this treatment is carried out, any space remaining between the tooth socket and the implant is grafted with bone substitute material to maintain the natural volume of the area as much as possible.
  • Sinus elevation and grafting -Following the loss of the upper posterior teeth, bone can be lost which can allow the air sinus in the area to increase in size (pneumatisation). This in turn means that there is a slight shortage of bone height for implant placement in these areas. In order to replace the volume of bone in these areas to allow the successful placement of implants a sinus elevation and grafting procedure may be required. This is a more involved procedure but one which we carry out regularly at our clinic.

During this procedure the sinus is accessed and the lining gently elevated allowing bone graft material to be placed forming increased foundation for the placement of implants. With this procedure there are a number of matters that you should be aware of:

  • Bovine bone graft material is used for the sinus graft.
  • Following sinus elevation and grafting it is normal to expect some swelling, tenderness and bruising in the form of a black eye, which will resolve in the week or so following surgery.
  • Infection in the region following surgery is unlikely but not impossible.
  • During the elevation of the lining it is possible that the sinus lining can be torn or damaged. Small tears are of little significance but larger tears may cause the procedure to be abandoned for completion at a later date.
  • If you suffer or have suffered in the past from chronic sinus conditions you must advise our team of this situation.
  • Block grafting – This is again a more invasive procedure which involves the harvest of bone blocks from the patients remaining dental bone with the repositioning of these grafts in the areas in which they are needed.

At PFAD we always invest heavily in the latest techniques and much of our bone grafting procedures are carried by using Piezo surgery techniques, which keep bone work as atraumatic as possible.

While grafting procedures are carried out to cause as little trauma as possible, these can be invasive procedures and it is normal to expect some swelling, tenderness and bruising afterwards.

The true extent of this depends on the individual but will always be controllable with routine analgesia if required and will generally resolve in the 7-10 days following surgery.