Dental implants are an increasingly popular way for people of all ages to replace missing teeth. While age alone does not prevent someone from being a candidate for a dental implant procedure, certain underlying health conditions may.
One such health condition that impacts candidacy for dental implants is insufficient jawbone required to properly support the device. Fortunately, patients may still be able to receive dental implants if they first undergo a dental bone graft. By placing synthetic material or bone taken from another part of the body, bone grafts help reinforce the jawbone.
To better educate patients on the treatment, this article will examine how dental bone grafts function, what the procedure entails, and what results the patients can expect.
What Are Dental Bone Grafts?
While there are various ways bone grafting procedures are performed, the basics are the same: An oral surgeon or dentist makes an incision into the jaw and attaches (grafts) additional bone material to the area. Usually, dental bone grafts are performed when the patient has lost one or more permanent teeth or suffers from periodontal (gum) disease as these conditions can both cause bone loss.
There are four types of bone grafts used in dentistry with each carrying its own advantages and disadvantages:
- Autograft: Uses bone taken from the patient’s body; typically from the hip or jaw.
- Allograft: Involves placing bone taken from a donor; typically a cadaver.
- Xenograft: Uses bone tissue taken from another species; often from a pig or cow.
- Alloplast: Uses synthetic tissue; calcium sodium phosphosilicate (Bioglass) or calcium phosphate.
Considered the gold standard, autografts are the preferred method for dental bone grafts. By using bone taken from the patient’s tibia, hip, or jaw, these grafts provide increased bony support while promoting faster healing and formation of new bone.
Who Are Good Candidates for Dental Bone Grafts?
Some common reasons why a person may require a dental bone grafting procedure include:
- Support Dental Implants: As mentioned, it is not uncommon for dental implant patients to first need a bone graft prior to implant surgery. The small metal dental implant posts act as replacement tooth roots on which replacement crowns are mounted. Critical to the long-term success and effectiveness of a dental implant is the fusion process, called osseointegration, that occurs between the jawbone and implant. To ensure a strong enough base to support an implant, bone grafting is sometimes necessary.
- Gum Disease or Tooth Loss: Dental bone grafting is sometimes needed regardless of whether the patient is getting implants. In cases of gum disease or tooth loss, bone grafts can help support the effected area of the jaw. By stabilizing the jaw with additional bone, grafting can help prevent additional bone loss and the potential long-term complications that could arise. Managing gum disease is always important as left untreated, it can lead to the loss of additional teeth and health conditions like heart disease.
- Bone Loss: People whose appearance is impacted by bone loss are also good candidates for dental bone grafting procedures. When jawbone mass is lost, the face can appear visibly shorter than normal. Should bone loss occur in the lower jawbone, it can cause the jaw to protrude forward. In the absence of healthy bone structures to support them, the appearance of the lips and surrounding muscles can change leaving the skin around the jaw area to look wrinkled. Jawbone loss and conditions like osteoporosis increase with age so the need for bone grafting rises with age.
Are Dental Bone Grafts Painful?
Answering this question will depend on the type of bone graft performed. Bone grafts that do not involve bone harvested from the patient’s own body, are relatively minor procedures. The procedure will be performed under sedation so there is no pain until the anesthesia begins to wear off. At that point, any pain is generally manageable with over-the-counter pain medications in the initial days following surgery. Depending on the extent of the grafting done, prescription pain killers could be appropriate, and discomfort may be experienced for several weeks while recovering.
Should an autograft be performed, recovery can be longer and more painful. This is due to surgery being done on two areas of the patient’s body (i.e. the hip and the jaw). The amount of harvested bone used in the grafting procedure is generally small so discomfort should not be prolonged in recovery.
How Much do Bone Grafts Cost?
Dental bone grafts can vary in cost considerably. The two main factors that influence cost are the materials used and the procedure’s complexity.
When the bone material used is synthetic, from an animal, or from a cadaver, cost can range from $400 to $1,200. Should an autograft be used, and bone harvested from the patient’s own body, cost can rise to $2,000 or more.
In most cases, insurance carriers, including Medicare, do not cover dental bone graft procedures. Should a doctor deem the procedure medically necessary, insurance could cover a portion of the procedure. But if grafting is performed for cosmetic purposes, it is not likely that any insurance assistance will be provided.
Bone Graft Recovery and Aftercare
Following a dental bone grafting procedure, the dentist will likely pack the area around the incision with gauze. Instructions will be provided for changing the dressing over the next day and antibiotics will be prescribed to prevent infections. If necessary, prescription pain relievers may also be administered. The jaw typically will begin feeling normal after a few weeks but could require a few months until it is strong enough to support implants.
Additional aftercare tips include:
- Applying cold compresses or ice packs to reduce swelling and discomfort for the first couple days.
- Sticking to a diet of bland, soft foods a few days following surgery (yogurts, apple sauce, cottage cheese, etc.).
- For the first night or two, sleep with the head elevated slightly to avoid blood from pooling around the incision site.
While initially recovering, patients should avoid:
- Hot foods or drinks like soup, coffee, or tea.
- Crunchy or hard foods like nuts or potato chips.
- Strenuous physical exertion that could elevate the heartrate and exacerbate bleeding.
- Contact sports or anything that could cause trauma to the incision.