Bone Grafting

A dental implant is a titanium screw that’s fitted into your jawbone, replacing the tooth root. To be suitable for an implant, your jawbone needs to be thick enough to support it.

There are some reasons why you might not have enough bone. When teeth are lost or extracted, the bone surrounding your tooth root can shrink gradually. Gum disease, infections and injury to the mouth can also lead to bone loss.

Bone augmentation or grafting is a solution. Both procedures replace lost bone using either bone from another part of your mouth, or one or more types of substitute material.

Depending on how much bone shrinkage has occurred, there are various treatment options available, including: 

• Minor Bone Augmentation: Also called simultaneous augmentation, this procedure can be performed around an implant while it’s placed.
• Staged Bone Graft: If too much bone has shrunk, a staged bone graft may be required six months before the implant is placed.

During your dental implant consultation, your dentist will carry out a thorough clinical assessment to find out if you’ll need bone augmentation.

They may also take a 3D scan to show the thickness of the bone, which can’t be seen on a normal X-ray.

The cost of a bone graft or augmentation depends on your requirements. During your consultation, your dentist will determine the specific treatment you’ll need and talk you through the likely costs.

They’ll then produce your bespoke treatment plan, giving an accurate estimate of the costs, timescale, risks and benefits of your treatment.

There are often two materials involved in a bone graft or augmentation: bone filler and a barrier membrane.

• A Bone Filler
  The material that replaces the bone that’s lost. Some common bone fillers include:
  – Your own bone can be used for filler, which is called an autograft. Bone may be collected from the implant placement site or another site in the mouth.
  – Bone made from animal biomaterials. This is called a “xenograft” and has been used safely for decades
  – A completely synthetic material called an “alloplast,” created in a laboratory
• A barrier membrane: to protect the bone graft material as new bone develops, your dentist will cover the graft with a coating called a barrier membrane.Resorbable membranes can be used, which dissolve and don’t need to be removed, or non-resorbable, which need to be removed surgically.

Minor Bone Augmentation

If minimal bone loss has occurred, minor bone augmentation, also known as simultaneous augmentation, can be used. It can be performed during implant placement and increases the amount of bone around an implant, to ensure your gums stay healthy.

The graft material used often includes some of your own bone, mixed with a bone filler, and is covered with a collagen barrier membrane.

It’s normal to experience some discomfort, swelling and bruising for approximately one week after this procedure.

Staged Bone Grafting

If there’s too much bone loss to be able to place an implant in the correct position, a staged bone graft can be performed.

The graft material could include some of your own bone, taken from your lower jaw, or a donor bone block (an allograft), depending on your preference. This may be mixed with a bone filler and will be covered by a barrier membrane.

A staged bone graft needs to be performed six months before an implant is placed, to allow your mouth to heal. During this time, your own natural bone will develop within the grafted space.

Side effects may include some discomfort, swelling and bruising for approximately one week after the procedure.

Ridge Preservation

A part of your jawbone contains sockets for the roots of your teeth, and this is called the alveolar ridge. When teeth are removed, the bone and ridge they are sitting in gradually shrink. The more the bone shrinks, the more difficult it is to place an implant in exactly the right position.

If your implant surgery is delayed for over a few months post extraction, it can be helpful to place bone filler into the socket(s). This helps avoid the shape of the ridge shrinking.

After a ridge preservation procedure, the extraction site may be slightly sorer than it would be from just after an extraction.