Why does bone matter so much?
Bone grafting is obviously really important. In our face and jaw, bone gives our face its shape, holds our teeth in place and protects everything inside: nerves, sinuses, airways… When bone is destroyed by infection, it has a huge impact on how we look as well as how we function and even how protected our nerves and airways are.
Is there any way to repair bone?
In the past, bone loss was bone loss. It occurred because of tooth loss and infections and there was no way to stop it once it started and no way to repair it. Thankfully, these days we are able to actually re-build lost bone with bone grafting and bone contouring to give our patients a second chance at a healthy foundation for smiles.
What is bone grafting?
Bone grafting is a special surgery that fixes bone problems by transplanting healthy bone in place of damaged, infected or missing bone. The magic of a bone graft occurs as the body accepts the new bone and begins to integrate it and build around it providing a strong new foundation for dental implants.
When is bone grafting necessary?
Think about a dental implant as a fence post. If the post doesn’t go deep enough in the ground or if there isn’t enough ground around the post, the whole section of fence is gonna fall over as soon as the neighbor’s kid runs into it with their bike. Similarly, the last thing you want for your new implant teeth is for a tough cookie to take out your teeth. Dental implants need to be well-rooted in solid, healthy bone in order to last. Bone grafting is our way of creating that bone when the bony ridge of the jaw is too shallow, too narrow or too damaged. It is critical to replace the missing or damaged bone with a bone graft in order to insure a successful implant outcome.
Four Types of Dental Bone Grafting:
- Pre-Implant Site Preservation: This type of bone grafting helps protect and preserve the bone in an area when a tooth is extracted. It happens either at the extraction appointment or shortly thereafter and involves cleaning out any infected or defective bone and replacing it with healthy bone. This is particularly important if bone is lost during an extraction, which can happen if bone has to be removed to release the tooth or if there is infection present.
- Implant Placement Bone Graft: When a tooth is removed and an implant is surgically placed in the root area, a gap between the implant and the bone could be grafted with bone graft. Without grafting this gap, bone loss and esthetics complications will likely arise. When this gap is grafted, chances are bone is preserved and the treatment outcome is highly successful.
- Lateral Bone Augmentation: Lateral augmentation is the process of widening a bony jaw ridge when bone loss has left it too narrow or thin. The augmentation targets future implant sites to provide wide enough bone to accept and retain an implant successfully.
- Sinus Lift: Most people don’t realize it, but the roots of their upper molar teeth rest near the floor of their sinuses. These are the same sinuses that bug us during allergy season and during colds. When bone loss occurs in the upper jaw, the maxilla, the distance between the roof of your mouth and the floor of your sinuses shrinks bringing them closer together leaving very little vertical space for a dental implant. In order to provide the bone needed for the implant and to prevent an implant surgery from puncturing the floor of the sinus, it is necessary to widen that bone back to the proper depth. This is done by inserting bone at the floor of the sinus “lifting the sinus,” so that your new implants and your sinuses can be happy and safe. It can be tempting to feel scared at the idea of “another surgery” and to wish that the dentist could just “try to place the implants” without the sinus lift. What most folks don’t realize is that this procedure is significantly less trouble than puncturing the sinus and experiencing an infection thanks to the sinus having the opportunity to spread bacteria into your brand new implant. Sinus lifts are the key to being able to successfully place implants in patients with severe vertical bone loss in their upper jaws.
Implants are Expensive Enough… Is Bone Graft REALLY Necessary?
We occasionally meet patients who want implants, but are feeling stretched financially and don’t want to include bone grafting because it just seems like an expensive add-on service.
We get it. It’s always frustrating to hear about extra expenses, whether it’s a car repair or your mouth. The key is figuring out if bone grafting is truly “optional.” Often, bone grafting is the key that insures successful implants. We can’t imagine anything worse than paying a lot of money for beautiful new teeth and watching them fail for lack of bone.
At Alamo Dental, we recommend bone grafting when we see that the implants have a high chance of failing without it. Implants fail when there isn’t enough bone vertically, horizontally or if the bone is damaged.
If you don’t feel comfortable because bone grafting just doesn’t seem necessary, schedule a time to review your CT Scan with us and ask your questions and get answers. We are just like you when it comes to our health: we don’t want to spend money if we don’t have to and we want a great outcome. Bring your questions and let’s have a coffee & 3-D CT talk. We want you to feel confident about everything you have done in our office!
Not Sure If You actually NEED an Dental Extraction?
Hearing you need an dental extraction when you’re not sure why it’s necessary. How can you know if the tooth truly needs to come out or if it could actually be restored? Isn’t it best to keep your own teeth as long as possible?
We meet new patients all the time coming in for a second opinion and feeling frustrated that another dentist wanted to take a tooth out that the patient is pretty sure could be saved. What we’ve discovered is that about 5% of the time, there was a restorative option available that was overlooked. However, about 95% of the time, the tooth needs to be extracted and the diagnosing dentist simply didn’t take the time to adequately explain why.
It’s easy as a dentist who “does teeth” all day long every day, to forget that patients don’t “do teeth” all day long and that they need extra information in order to feel comfortable making decisions, especially about losing teeth. Dentists also have different personal guidelines about what “saving a tooth” means.
Here are my personal guidelines for when teeth should be extracted:
- If the tooth has an untreatable level of infection inside the tooth
- If the tooth has an untreatable level of infection in the surrounding gums
- If the bone around the tooth has dissolved and can’t support the tooth
- If the tooth has broken or decayed to the point that it can’t support a crown
- If the tooth has already been root canaled twice
Why these guidelines? Because I don’t believe that fixing a tooth just to have it break again in a month counts as “saving a tooth.” Every one of these scenarios could be patched, but would explode as a toothache, dangerous infection or deeper trauma within days or weeks, further risking your health. I’m not willing to put my patients’ health at risk for convenience.
If you’re not sure why your tooth “needs an dental extraction” come see me for a second opinion. We’ll take a look and a 3D-CT radiograph give you a clear explanation of what is going on either with that one tooth or in your whole mouth depending on how much you’d like to know.