Bone Grafting

Bone grafting is commonly used to restore implant sites that otherwise do not have adequate bone structure due to previous extractions, gum disease or injuries. Today, we have the ability to “grow” or “develop” bone where needed.

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, patients may not be good candidates for placement of dental implants. Successful grafting provides the opportunity to place implants of proper length and width. It also gives us a better chance to restore function and esthetics. Please call us with any questions about bonegrafting in Wilmington, DE, 302.477.1800.

Sometimes the area in need of grafting is relatively minor in size, while at other times large areas of the jaws must be reconstructed. Major bone grafts are typically performed to repair large defects that may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone, harvested from a number of different sites depending on the size of the defect. These procedures are routinely performed in an operating room and require a hospital stay.

Bone for grafting may come from a bone bank (cadaver), from your own body (autogenous bone), or be from some other source. They type and size of the defect usually determines they type of bone required. When your own bone is used for grafting, it may be harvested from your jaw, hip or tibia (below the knee) or other site(s).

Sinus Lift Grafting

The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are hollow cavities that serve to warm and humidify the air we breathe. When these upper teeth are removed, the bone separating the mouth from the sinus cavity begins to atrophy. Since dental implants need bone to hold them in place, when the bone becomes very thin, it is impossible to place implants in a manner that will likely succeed.

Sinus grafting makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures or other prosthesis.

Procedure

This graft involves placing bone into the bottom of your maxillary sinus with the intention of increasing the total volume of bone in the posterior maxilla (upper jaw). Dr. Rafetto enters the sinus through a gum incision along side of the upper jaw where the upper teeth are or used to be. The membrane that lines the sinus is lifted upward and the graft is inserted into the floor of the sinus. Usually this involves the placement of a limited amount of your own bone (generally taken from a near by area of your jaw) combined with bone from another outside source, such as cadaver bone. After several months (6 – 8) of healing, dental implants can be inserted and stabilized in this new grafted tissue.

On occasion, enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well enough that sinus grafting and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus graft will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

Ridge Expansion

In some cases, the bony ridge has been reabsorbed and a graft is necessary to increase ridge width only. This technique is used to restore the lost bone dimension when the jaw ridge gets too thin to place conventional implants. In some cases, the bony ridge of the jaw is expanded by mechanical means. Bone graft material can be placed and allowed to mature before placing the implant. In other cases, bone is grafted along side the ridge to recreate the proper dimensions to place an implant or implants.