Jaw bones are designed to hold the teeth in place, but when that bone is attacked by periodontal disease or a person loses a tooth, the bone begins to deteriorate.
In those situations, Dentists combat the harmful effects of bone loss through bone augmentation procedures. Bone augmentation adds extra bone to necessary areas to compensate for the lack of structure.
It is important to take steps to build up the bone in these circumstances because it will continue to deteriorate if left untreated.
Bone augmentation is a term used to describe a multitude of procedures designed to replace and restore bone, most commonly in preparation for dental implants.
It also commonly is performed after tooth extractions. If the space is left alone after a tooth extraction, the bone in that area will begin to wear away.
Dentists perform these office procedures by grafting real or synthetic bone to the jaw. The best results come from harvesting bone from the patient for the augmentation. When the patient’s bone is used, it most often is taken from the chin or the back part of the lower jaw.
If dentists are unable to get enough bone from either of these areas, they may have it harvested from the hip or shin instead. The hip is thought of as a good source because it contains plenty of marrow filled with bone-forming cells.
Other sources of bone are human cadavers or cows. Synthetic materials also are available.
Bone augmentation can be performed on almost any patient. Patients do not have to be in perfect health, but there needs to be enough stability in the body to be able to recover properly.
If you have to add bone to the existing bone structure after years of a tooth or teeth having been missing, that’s a little bit more involved and complicated than just adding the bone at the time of extraction. Adding at the time of extraction just fills the area up so the bone will heal correctly. If they’re doing this to increase bone volume for implants, it’s a bit more complicated.
Bone augmentation usually is performed under local anesthesia. However, more involved cases such as adding bone to the sinus area or removing bone from another area to add to the jaw can be performed under general anesthesia.
A common situation requiring bone augmentation is a patient who lost a tooth several years ago and wishes to have a dental implant and crown put in the missing tooth’s place. Because the area has gone untreated for a length of time, the bone typically has begun to deteriorate. Real or synthetic bone is put in the area to strengthen it, enabling it to support a dental implant.
The dentist numbs the area and makes an incision in the gum where the implant will be placed to determine the amount and type of bone needed. An incision is made in the area where the bone will be harvested and a block of bone is removed. Some dentists fill this area with a different type of bone-graft material and cover it with a membrane to prevent soft tissue from filling the space as it heals. The incision then is sutured.
Harvested bone is placed in the recipient site by drilling tiny holes in the existing bone to cause bleeding. The bleeding provides cells that assist the bone during the healing process. The block of harvested bone then is secured in place with titanium screws. A combination of the patient’s bone marrow and some other bone-graft material are placed around the outer edges of the harvested bone and a membrane is placed over the area before the incision is sutured.
Once the bone augmentation procedure is completed, the healing process begins. The patient is given antibiotics, pain medication and an antibacterial mouthwash. Certain foods must be avoided for a period of time while the area heals. For patients who have natural teeth near the bone graft, they may be given a temporary, removable bridge or denture to aid in protecting the area.
It can take anywhere from six to 12 months for the grafted material to fuse itself to the existing bone. At that point, the patient can undergo the dental implant procedure to restore their missing tooth or teeth.