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Bone Grafting

Bone grafting is a procedure, which may be required either after tooth extraction, before dental implant placement as in a sinus lift, or during dental implant placement.  In this section we will discuss the purpose of a bone graft, the different types of materials used for grafting as well as the cost of bone grafting.

 

Purpose of a Bone Graft

The main purpose of bone grafting is to preserve or increase the amount of the bone that is present in the surgical site.  Bone grafting is commonly completed after tooth extraction or during a sinus lift procedure.  After the grafting material is placed it is resorbed by the body and replaced with our natural bone.  This will either stabilize or slightly increase the level of bone.

After a tooth is removed and the extraction site is allowed to heal on its own, the vertical height of bone will naturally decrease due to alveolar bone resorbtion.  By placing a bone graft we are able to stabilize the alveolar ridge, the bone that holds the teeth in place, which means that after the tooth extraction site heals the bone height should be similar to pre-extraction levels.

Bone grafting during a sinus lift procedure will increase the amount of bone available for dental implant stabilization.  Without the graft, part of the dental implant can sit in the nasal sinus cavity without any support.  This could lead to potential failure of the dental implant in the future.

Another common use of bone grafting is to fill in any structural bone defects during implant placement surgery.  This allows the surgeon to smooth out the bone circumventing the dental implant.

A less common use of bone grafts is to repair any defects in the natural bone, which occurred either naturally or were caused by the surgeon.

 

Bone Graft Material

Lets discuss possible sources of a graft and the variety of bone grafting materials available on the market today.

One of the most common sources of a bone graft is the actual patient that is undergoing dental surgery. This type of graft is called autogenous.  The bone can be obtained from the oral cavity or other sites in the body.  The patient is an excellent source for grafting material because there is no risk of an immune reaction to the patient’s own tissue.  However, this usually means that surgical trauma is inflicted on another part of the patient’s body.

Another type of grafting material is undecalcified freeze-dried bone or decalcified freeze-dried bone. Both of these are considered allografts, which means the source is the same species as the recipient.  Cadaver bone is the source of the graft.  It is important to mention that numerous steps are taken to eliminate viral infectivity of the sample.

Bovine-derived bone is a very popular and effective graft material.  It is classified as a xenograft because the source is a different species than the recipient.  It is also important to mention that the bone is chemically treated and sterilized. It has been used very effectively in correction of bony defects.

The last type of graft product is a non-bone graft material.  These include but are not limited to dura, cartilage, cementum, dentin, plaster of Paris, plastics materials, coral-derived materials and ceramics.  Sterilized Plaster of Paris has showed a lot of promise. The other substances do not offer a reliable substitute to natural bone graft materials.

 

Cost of a Bone Graft

Cost of a bone graft can vary greatly.  The cost is usually determined by the type of graft placed and the type and amount of grafting material used. The actual price can vary from $200 to $1200 and higher.   Dental implant patients sometimes will question the necessity of a graft in the dental implant placement procedure.  Even though the bone grafting can increase the cost of dental implant placement considerably the benefit of a healthy and stable dental implant over long term is definitively worth the cost.


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