Bone Grafting

What happens when missing teeth are not replaced?

Missing teeth can be caused either by gum disease, previous extractions, or injury. When they are not replaced, the jawbone that once held the missing teeth in place can be damaged. The jaw bone can die or get absorbed by the body over time. This makes the bone weaker and not able to support a replacement tooth/dental implant.

Sometimes the gums look like they are normal and there are no problems. Performing pocket depth measurements may reveal severe pocket depths as well as bone defects.

In the first 6 months of losing a tooth, one could lose 40% of the original amount of bone. Bone loss continues with time. The rate of bone loss depends on various factors and differs between individuals.

Eventually, the bone resorbs to a level where replacement of the missing teeth with dental implants is not possible. Bone grafting is used to rebuild the bone that was lost so a replacement tooth/dental implant can be put in.

Treatment Goals

Bone grafting can be used to accomplish various treatment goals:

It can be used to save teeth that are at risk of falling out due to severe gum disease
After a tooth extraction if the patient should want to replace the missing tooth with a dental implant later on.
Before the placing of dental implants in order to regenerate enough bone to successfully place the implant

Bone Grafting Materials

Bone grafting materials can come from:

Synthetic bone
Animal bone (cow)
Donated bone
Your own bone

How does guided bone regeneration work?

The graft acts as the foundation for rebuilding the bone. Once the graft is placed, your body fills in the area with its own new bone via guided bone regeneration. This makes a strong foundation for a replacement tooth.

Guided bone regeneration techniques use the body’s natural process of bone remodelling. Osteoclasts are cells in our body that resorb the bone graft, removing it from the grafting site. Osteoblasts are cells in our body that replace this bone with the patient’s own new bone.

Through this process of removing and replacing bone, our bodies are able to remove the bone grafting material and replace it with our own new bone.

What to expect during the procedure

The gums are cut in order to make a flap. This flap is pulled back in order to expose the bone underneath.

A bone substitute is placed to fill the areas of bone loss.

It is recommended that a membrane is used to cover the area and prevent the soft tissues (gums) from growing into the spaces. This membrane keeps the shape of the new bone as well.