Bone grafting and bone substitutes

Dental implants rely on your jaw bone for support - quite simply, if there isn't enough bone to support them, then the implants will not succeed.

There are many reasons why there may not be enough bone – infection, trauma, periodontal (gum) disease, and a natural tendency for the bone to shrink back once a tooth is lost.

Fortunately, there are a number of treatments available to help replace missing bone, so that you can still benefit from strong, long-lasting implants.

Most of these involve different bone grafing techniques. These are used to replace missing bone, as well as to increase the height and width of the bone. Sometimes the technique can be relatively simple – we can collect bone when preparing an implant site, and then re-use it to fill in any defects. Very often, synthetic bone substitutes can be used – these work by stimulating the body’s own bone to grow, repairing the damaged areas.

More often than not, these techniques are used in combination with special membranes which are laid over a graft site to stabilise it and help promote good bone formation. These membranes are absorbed into the body, and disappear without further treatment.

The grafting treatments can also vary according to the site where additional bone is needed.

Bio-Oss

Geistlich Bio-Oss® and Geistlich Bio-Gide® are natural products. Due to the great similarity to human tissue, these materials are optimally suited to promote new bone formation and tissue healing in the human body.

They are integrated into the tissue in the course of healing, and are then broken down gradually by the body‘s own metabolic processes. This process may take several years for Geistlich Bio-Oss® while Geistlich Bio-Gide® is broken down completely after a couple of months.

Geistlich Bio-Oss® is made from the mineral part of the bones originating from Australian cattle. During manufacture, the organic constituents are removed, so that only the hard bone structure consisting of calcium compounds remains.

Geistlich Bio-Gide® is a membrane prepared from collagen (animal of origin: pig). In the human body the protein collagen is the main component of skin and connective tissue. The natural protein structure of Geistlich Bio-Gide® promotes wound healing and allows optimal bone regeneration by acting as a protective barrier.

For more information view the patient leaflet from Geistlich.

Sinus lift

Some of your upper teeth share the same bone space with your sinuses (air cavities near your nose). If you lose one of those teeth, the bone around it can shrink away. In addition, the sinus space can expand downwards. The end result can be a combination of the sinus cavity being too close to the implant site, and not enough bone to support the implant.

The treatment involves opening up a small area of the bone from the gum, and gently moving the sinus membrane up and away from the jaw. We then place the bone grafting material into the space where the sinus was, and stitch up the gums. Over time, the material bonds with your natural bone, forming a strong support for an implant.

Ridge preservation

As the name suggests, this treatment is more about preserving your bone material than replacing bone which has been lost. When you lose a tooth, there is a space, or socket, where the tooth root was. Without the tooth root there to stimulate the surrounding bone, it starts to shrink away from the socket area. If you lose too much bone, it may not be possible to place an implant – there simply won’t be enough bone to support it.

Ridge preservation involves filling the tooth socket with bone grafting material, usually in the form of granules. A cover is placed over the top to help keep the area clean and to aid the healing process, and the gum is stitched up. The bone substitute stimulates growth of new bone over time, forming a strong support for an implant.

Autograft/Block Graft

When you lose a tooth, the bone surrounding it is no longer needed, and it shrinks away. If you lose several teeth in one area, the bone loss can be very significant, leaving you with a much thinner bone, or ridge, and making it impossible to place implants without a bone graft.

Autograft treatment involves taking a small amount of bone from another area – usually a different part of your jawbone, your chin, and securing it to the area of bone where the implants will be placed. Both sites – the one where the bone has been taken from, and the one where it has been added to – have bone grafting material, usually in granule form, added to help the healing process.

A membrane will also be added to hold the grafting material in place and help the healing process. This membrane is gradually absorbed into the body. Over time, the bone around the implant area heals to provide a strong and secure foundation for your implants.

For more information on bone grafting, call our practice in Warwick on 01926 491029 or book an appointment.