Before answering this question, it is necessary to explain that there are different dental bone grafting techniques, each with its own complexity and extent. This directly influences the guidelines for the post-operative period and recovery time.
Learn all about bone grafting with implants
In most cases it is possible to use a prosthesis while the graft heals
Dental bone grafting to allow the placement of just one implant, where the patient has teeth to be used as support for the prosthesis, is not the same as block grafting to place several implants in a full arch, which is considered more complex.
However, in many cases, it is possible to attach a temporary resin prosthesis, which is suitable for helping the tooth graft recover and heal, as well as allowing the patient not to be without teeth for the duration of the treatment.
After the recovery period, the temporary prosthesis is replaced by a permanent prosthesis made from the material chosen jointly by the patient and the dentist (resin, metal-ceramic or fully esthetic zirconia).
Particulate grafting is used in small reconstructions, such as filling in a site where there has been bone loss or in the maxillary sinus lift technique. The biomaterials used in particulate bone grafting are implanted to replace or repair atrophied tissue.
They can be of natural origin (a small amount of crushed human bone from the patient themselves or from a tissue bank for transplants, or freeze-dried bovine bone powder).
The particulate graft can also be made of synthetic material produced in the laboratory, fully biocompatible with osteoconductive properties (attraction of bone tissue-forming cells) or synthetic vitreous materials (synthetic hydroxyapatite).
The particulate dental graft is deposited in situ and then covered with a collagen membrane. In favorable cases, the dental implant can be placed on the same day as the graft, followed by a temporary prosthesis.
Block Grafting
This technique is indicated for more extensive reconstructions. The block-shaped tooth graft can be taken from another part of the patient’s body. When only one block is needed, it can be taken from the mandible.
When more blocks are needed, they can be taken from the pelvis or skullcap. None of the donor sites suffer from bone loss. The blocks are fixed in the jawbone with titanium screws and will thus allow more dental implants to be placed.
The possibility of using a prosthesis in this type of graft is therefore assessed on a case-by-case basis.The ImplArtDental Clinic has extensive experience in dental bone grafting techniques.
If you have any questions, please contact us or book an appointment.
Bone grafts are techniques to supplement the bone lost in the patient’s jaw. They can be performed simultaneously with the insertion of the dental implant, or require a healing period. Each indication will depend on an analysis of the patient’s case. But rest assured, today’s bone grafting techniques are very modern and painless for the patient. The results are certainly worth it because dental implants are the best solution for restoring missing teeth!
Know everything about dental bone grafts
Bone grafts are used to reconstruct the area that has lost height or thickness
In some cases, it is not possible to place dental implants without first doing bone grafts. People who have lost one or more teeth due to accidents or extractions always think about reconstructing their dental arch in order to smile without embarrassment and for this, dental implant placement is certainly an excellent option.
When people lose their teeth and don’t replace them immediately, they experience bone resorption. As a result, the bone in the area becomes thinner and taller, or has defects in its shape. In the upper jaw, the size of the maxillary sinus can increase, which in principle prevents implants from being placed. In addition, with tooth loss, expressions become limited, the mouth shrivels, chewing becomes difficult and speech can also be altered.
In this way , bone grafting serves to rebuild enough structure to allow the implant to be made, restoring the lost volume to the atrophied bone. For this technique, the dentist can use the patient’s own bone material, taken from the mouth (for small reconstructions) or taken from other sites, such as the hip bone (iliac) and skull cap (for large extensions).
There are different bone grafting techniques, each with its own particularities
In the case of smaller, more common grafts, the bone grafting procedure can be done in the office using local anesthesia. For larger areas, the surgical intervention is performed in a hospital by a larger, multidisciplinary team under general anesthesia. The patient does not lose teeth while the bone graft heals.
It is also possible to use a xenogenous bone graft crystal, when the bone comes from animals (freeze-dried bovine bone – Genox or Bioss), human bone from bone banks (bone transplant) or synthetic vitreous materials (synthetic hydroxyapatite). However, the most easily regenerated material is bone graft taken from the person themselves (autogenous bone).
Types of bone graft materials
The procedure can be carried out in fragments or as a block. Many people are afraid of undergoing a bone graft, but in fact the procedure can be very simple. All the materials are biosecure and undergo strict controls to prevent contamination.
Smaller bone grafts are non-invasive and can be used to supplement the bone around a newly placed implant. However, in people who have lost their teeth many years ago, larger bone grafts may be necessary. ImplArt’s philosophy is to avoid bone grafts and has mastered alternative techniques such as:
Bone loss can occur for a number of reasons, but the most common is tooth loss or extraction without immediate replacement. When a person loses their teeth, the body resorbs the bone in the maxilla or mandible because it understands that the bone no longer has a function (which was to provide support for the teeth). This loss is progressive and over the years the person has little bone volume in terms of height and width, which at first makes it difficult to place dental implants.
What are bone grafts?
Maxillary sinus lift or sinus lift
A sinus lift is a surgical procedure for bone grafting in the posterior region of the upper jaw. The aim is to increase the amount of bone in height so that a longer dental implant can be placed.
When a person loses one or more teeth in the upper arch, there is a loss of bone in height and the maxillary sinus shrinks (fig.1). The procedure is carried out in this way: First, a small opening is made in the gum in the lateral region of the bone defect (fig.2).
A variable amount of bone regeneration precursor material is then placed inside this opening (figs.3,4). The surgery is quick and usually takes no more than 30 minutes with an experienced surgeon. Bone regeneration takes between 4 and 9 months (fig.5), and then the implants are placed (fig.6), but radiographic examinations are carried out beforehand to check the progress of bone regeneration.
Materials used in bone grafts
Nowadays we have a variety of materials that can be used for bone grafts in the maxillary sinus:
Studies show that all materials are favorable for this type of graft, depending only on the surgeon’s preference.
Bone Graft Before and afterBone Graft Before and after – X rays
The ImplArt Clinic has experience in various grafting techniques
Dr. Roberto Markarian, coordinator of Clinica Dentaria ImplArt, is an experienced dental implant specialist with thousands of implants installed. Due to his extensive clinical and surgical experience, he has been able to carry out countless cases of rehabilitation without the need for bone grafting and which had been indicated for grafting by other specialists.
Each case is assessed individually during a consultation. If you have any questions about the price of treatment, values or planning, please contact us or schedule a consultation 📲WhatsApp(11) 3262-4750. Bone grafts are different from gum grafts in terms of techniques and objectives.
Gum grafting is used to try and reconstruct an area of the mouth that has suffered from receding or lost gum tissue. Gum recession can occur due, for example, to brushing too hard, gum disease, bruxism or prolonged use of braces. To reduce the effect of the problem, gum grafting is usually indicated.
This is a surgical procedure that consists of removing a piece of mucosa from the patient’s own palate (roof of the mouth) and then placing it over the defect. The material is removed under local anesthesia and the person feels no pain, only slight discomfort.
When healthy, the gums form a protective collar around the tooth. There are two types of gum: the inserted gum, which is a pink, thicker tissue that surrounds the tooth and is adhered to by the bone tissue, and the mucosa (non-inserted gum), a thin, soft and highly mobile tissue that forms the inside of the cheeks and lips. When the gums are unhealthy, we first need to restore their health by removing the bacteria with a periodontal scraping.
Gum defect needs grafting
A gingival defect (receding gums) usually occurs as a result of gum inflammation, caused by a tooth fracture for example. It happens when the gum tissue retracts, almost always due to excessive force when brushing the teeth. The retraction of the gum tissue leaves the tooth root exposed, causing tooth sensitivity and compromising the aesthetics of the teeth. In the case of dental implants, receding gums can expose the base of the implants.
There can also be gum loss due to trauma, accidents or periodontal disease. In these cases, the gums lose their original shape and the aesthetics of the smile can be compromised, especially in the area of the front teeth. In some cases, the placement of dental implants leaves the gums with an inappropriate shape, and this defect can also be corrected with the gum grafting technique.
It is important to note that the gingival grafting procedure does not guarantee success. Even if the procedure is carried out perfectly in terms of technique, there may be tissue necrosis and a consequent loss of the grafted tissue.
After gum surgery
To prevent pain, the patient uses medication (anti-inflammatories) before and after surgery. The dentist can also use “surgical cement”, a protective barrier that is fixed in place where the operation took place. It sticks to the teeth and gums for around five days.
The donor area is not left unprotected after the procedure, as it is sutured (stitched) and this protection helps to maintain its aesthetics and shape, even after a small piece has been removed. Among the main precautions after gum surgery, diet is the most important. The patient should follow the post-surgical recommendations, which are the same as for implant surgery, eating soft, cold food for the first few days to avoid bleeding, infections, and to help with analgesia and healing.
Acidic foods should also be avoided so as not to irritate or sting the gums. As an alternative to gum grafts, prostheses can be made to disguise the aesthetic problem, either with more favorable tooth shapes or with prostheses containing artificial gum. Each case is assessed individually.
Dental bone grafting is a subject that often generates a lot of doubts and even fear in patients. It is a technique indicated for reconstructing bone structures in the mandible and maxilla when patients have little volume or defects, especially those who wish to place dental implants.
I don’t want dental bone grafting, do I have a choice?
Implants without dental bone graft: are there alternatives?
However, every patient is assessed individually. And today we have new techniques for bone grafting. In fact, for some, the indication of bone grafting is inevitable, while for others, there are alternatives to grafting, such as:
Short implants (little vertical bone volume)
Small diameter pins (little horizontal bone volume)
Roxolid Straumann reinforced titanium implants (smaller and stronger)
Short and narrow grafts can be an alternative to bone grafting techniques
Small bone grafts or micrografts are alternatives to bone grafts
ImplArt Odontologia’s philosophy is to avoid bone grafts as much as possible and has mastered alternative techniques to avoid their use whenever possible. By avoiding dental bone grafting, treatment becomes faster and the patient undergoes fewer surgical steps. However, nowadays bone grafts are small and very restricted to the implant site. In the past, only large grafts were performed.
That’s why the micrograft technique is better and has less pain after surgery. Dental implants without grafting before and after Dr. Roberto Markarian, the clinic’s coordinator, is an experienced dental implant specialist with more than a thousand implants installed, and cases of before and after implants.
Thanks to its extensive clinical and surgical experience, ImplArt has been able to treat countless cases without bone grafts – which may have been indicated by other specialists. The indication of techniques depends on a thorough examination of the patient, as well as their tests, such as CT scans and X-rays.
If you have them, come to your assessment appointment with all your tests. If you don’t have them, for your convenience they can be carried out in our digital radiology center inside the clinic (at a separate cost).
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