Importance of bone grafting in tooth extraction and restoration of teeth

With the boom of fast food and poor dietary habits, people undergo serious dental problems. In busy life, we do not spend more time in oral hygiene. As a result, we may suffer from dental carries, teeth decay, movable teeth and bone loss. Dental scientists continually explore effective ways to offer best dental solutions to their clients. When patients loss their bone due to long term periodontal diseases, bone grafting is advisable.

Bone repairing and restoring is done since long time. The surgeons of pre-incan period used gold and silver plates and shells as a grafting material to repair trephine holes in the skull 3000 years BC. Bone transplantation has common surgical procedure. A bone graft technique is performed to replace missing bone, to enhance bone formation or defect in a patient’s bone in order to restore form and structure. The bone grafting is advised when the jawbone has waned to the point where it can no longer support existing or replacement teeth. In normal course, the jawbone holds the roots of teeth in place, teeth depend on the steadfastness of the bone to keep from shifting when a person bites or chews. When a tooth is lost, the bone, which no longer serves the function of holding the root, begins to corrode until it creates a hollow cavity in jawline. Once significant bone loss is occurred, oral surgeon perform a bone graft before any replacement teeth can be placed.

Why bone grafting is needed:

Bone grafting is required when patients suffer from untreated gum (periodontal) diseases, extraction of a tooth, trauma, and various inflammations that cause bone weakening. Consequently, bone loss can also appear around existing teeth. Bone graft procedure performed by oral surgeon improve teeth integration. Furthermore, bone graft dental procedures are also required in areas without teeth, in order to insert implants and crowns thereafter. This will improve aesthetic results.

Treatment for Bone Loss in Teeth:

When patient’s teeth are extracted and the bone underneath is lost then a bone graft is required to be put in. Some dental conditions that can affect the bone beneath include:

-       Periodontal disease; infection and inflammation of the gums

-       Dental cavities

-       Long term denture usage

-       Trauma

-       Infection

-       Defective development of the teeth

Bone substitutes:

Several sources for bone material have been used by oral surgeons that include bone substitutes from a human origin (originating from human cadavers and marketed through bone and tissue banks), from various animal sources or from synthetic materials, which are lab-produced and not from a live origin. Presently, fresh autogenous cancellous and cortical bone remain the most widely used material for bone grafting.

Bond Apatite™ and 3D Bond™ are bone alternates and are based on the mineral biphasic calcium sulphate. This mineral fully resorbs and is substituted with the patient’s own bone. The material acts as a skeleton to build the new bone, and completely disappears as it rebuilds itself. Calcium Sulphate is a natural mineral used as a bone auxiliary. The calcium sulphate is used in the medical field since long time in bone enhancement. Calcium sulphate has extraordinary properties as a bone substitute and helps in bone formation.

Bone grafting material affect new bone formation at defected site in several ways. The material can induce bone formation through cellular signalling or through the transfer of osteocompetant cells or it may simply provide a scaffolding and having a space maintaining function for the host to grow new bone.

The bone graft dental techniques takes between 45-90 minutes, and is performed in dentist’s clinic by highly skilled surgeons. The initial recovery period lasts about two weeks. Following the bone graft procedure, the waiting time until a solid bone mass is received is between 3-6 months.

Different Types Of Bone Graft:

There are several bone grafting techniques for the enhancement and restoration of teeth:

1. Socket Grafting: When tooth has been lost due to infection or trauma and leave a cavity in the bone within the gums, then oral surgeon can opt to fill it with some graft material which acts as a base, around which bone cells will migrate and form a layer of new bone cells.

2. Ridge Augmentation: This techniques is performed in case of excessive bone loss after a tooth is lost. The dental surgeon uses an allograft in this case to fill the void completely to restore the former structure of the bone. The approximate cost of Ridge augmentation is about $4600 in the US.

3. Sinus Lift Procedure: This technique is performed for teeth missing in the upper jaw. An incision is made is the maxillary sinus or the area above the upper jaw. The sinus tissue is moved upward and bone tissue is filled into the cavity created. After the procedure is conducted, a dentist will wait for a few months to allow the jaw to heal and remodel, to support the implant.

The Post-Operative Care For Bone Graft:

After bone grafting procedure, patient needs keep ice packs on the gums to manage swelling and soreness. After the surgery, a dental surgeon generally prescribes antibiotics to prevent the development of an infection during the recovery stage. Pain killers also help with the pain. Patients will have to avoid wearing dentures for a few weeks in the healing stages after surgery.

Safety features of bone grafting:

Bone grafting must be performed by a highly trained doctor, then it is safe and reliable. All grafting materials are completely sterile and come from a reputable national tissue bank. The high success rate of the surgery is when surgeon uses bone material from patient’s own body.

Post-operative care for a  bone graft:

After bone grafting procedure, patients need to maintain oral hygiene. Teeth need to be brushed twice daily, followed by regular flossing and rinsing with mouthwash. Regarding the diet, patients must have to consume soft and pureed foods for the first few days after the procedure. They can take solid foods after a few days.

Failure of bone grafts:

Bone grafting has high success rate if done by trained oral surgeon. Still, there are likelihoods that the bone graft may not be successful for certain people. Negative results are found for people who smoke or have medical conditions that could exacerbate the pain. The most frequent complication of graft failure may be due to exposure of bone graft, improper stabilization of the graft, and infection.

Numerous factors that can pose the risk of a bone graft:

• Periodontal disease

• Smoking

• Osteoporosis

• Surgical errors

• Systemic conditions such as uncontrolled diabetes

• Immune system deficiencies.

Merits of bone grafting:

A bone grafting procedure is highly recommended for the patients who do not have enough bone to support a dental implant or artificial tooth replacements. Bone grafts can enhance the size and shape of bone and gums at the graft site and aesthetically more tempting. A bone graft procedure is performed to maintain the bone structure after a tooth extraction process.

Patients who must avoid bone grafting:

Bone grafting is not recommended for people who smoke overly as there are chances of failure due to delayed recovery and graft rejection. Any person who is suffering from an untreated periodontal disease must not undergo this procedure to avoid certain complications such as aggravated gum infection. Patients who have uncontrolled chronic disorders such as diabetes or heart diseases must not undergo this procedure.

Alternatives techniques of a Bone Graft:

Besides grafting bones, other techniques can be performed to build bone to place implants or alternative teeth replacement.

1. Ridge Expansion: This is performed when the jaw is not wide enough to support the implants. A saw is used to slit the jaw open and graft material is used to fill this space.

2. Distraction Osteogenesis: This process is performed by dental surgeon to increase the height of the lost bone within the jaw. A piece of bone is separated from the rest of the jaw and a piece of titanium is placed between the two sets of bone, the one sawed away and the one present within the jaw.

Important facts:

If a bone graft is not performed, without a tooth the bone withers away. This will affect future plans of replacing missing teeth with implants of other techniques.

In India, dental surgeon offer high quality treatment for dental problems at low prices. The country has accredited medical facilities, which guarantee the highest quality services to their patients. There is a huge team of qualified medical practitioners in India. The dental infrastructure in the country is well modernised with the newest technological developments in the field.

In nutshell, Bone grafting is helpful to enhance bones that are lost due to trauma or natural or pathologic process. It aids in retaining aesthetic of teeth. Bone grafting is a technique of the use of bone in reconstructive orthopaedics to repair skeletal defects and hasten bone healing. Bone grafts serve array of mechanical and biologic functions.

Important: This article is developed through environmental information, academic experience and personal view of writer. Writer is not responsible for any disagreement.