How Bone Grafts Can Restore Your Appearance
Periodontitis is a serious gum disease. Over time, if not treated, it will cause your gums to recede and your teeth may become loose and possibly even fall out. The erosion of your gums will certainly change your smile and make it less attractive and you will appear older. The good news is that your smile can be restored and missing teeth replaced with bone grafting.
About Bone Grafting
Dental bone grafts can be used to replace missing or lost bone in your jaw. It can also be used to prepare your jaw for dental implants, enabling your smile to be restored. An oral bone graft can also help to restore a more youthful look.
Periodontitis Destroys Bone
Gum disease starts as gingivitis, which is rather mild. There is very little physical damage taking place at this stage. The bacteria that cause gingivitis can usually be removed by brushing twice a day and flossing.
If oral care does not improve, it will become periodontitis. This means the bacteria that cause gum disease has gained entrance into the gums and an immune reaction has started. The immune system starts to attack the bacteria and the gums, along with the support structures for your teeth, and your jawbone. It will slowly erode them away and it will not stop until the bacteria are removed by a periodontist. Once the bacteria are removed and the gums properly treated, the bone loss will stop – especially with the presence of a dental implant.
Bone Graft Surgery
Oral bone grafting is a method that is used to build up the bone that has been lost to periodontitis. There are two ways that it might be used. The bone graft types include:
- Bone block – a small block of bone can be taken from another place, such as from a hip or chin. The block is shaped as needed and then screwed into place.
- Bone powder – processed bone is mixed into a paste and then shaped and applied as needed. On some occasions, tooth extraction and bone graft will take place at the same time. The powder or paste may be inserted into the socket immediately after extraction to help ensure that the bone retains its height while waiting for the dental implant.
After a bone graft, the original bone cells will mix with the new bone. Over time, your new bone cells will increase and they will eventually replace all of the bone graft material completely. This will leave you with only your bone once it completely heals.
When Bone Grafting May Be Used
Bone grafting is primarily used to restore bone that has been damaged or lost. The jawbone is normally partially reabsorbed into the body under any tooth that has been extracted. A bone graft for implant is often conducted to raise the height of the lost bone so that it matches the surrounding bone.
On some occasions, periodontitis can erode enough bone away from the jaw that it changes the shape of the face. A bone graft may be used to reshape the jaw so that the face’s original shape is regained.
Materials Used in Bone Grafts
The materials used in a bone graft will vary. The choice will depend on the periodontist’s choice (he or she may have a preference), but the patient may also have a preferred material.
- Your bone tissue (autograft) – Bone can be taken from your hip, legs, ribs, or chin.
- Donor bone material (allograft) – Bone may also be obtained from a donor (cadaver) at a tissue bank.
- Bone from an animal (xenograft) – Bone is obtained from an animal, such as a cow.
- Synthetic bone (alloplast) – It is becoming more common to use artificial bone material for a bone graft. The graft is often made of a combination of calcium, phosphorus, and a plastic called hydroxylapatite.
The Bone Graft Procedure
The periodontist will start the procedure by giving you local anesthesia, but stronger anesthesia can also be used if desired. The next step is to remove any gum disease. The gums will be opened and folded back to expose the bone and tooth roots (if you still have teeth). Bacteria and inflammation will be manually removed, along with any infected gum tissue and bone. In order to help prevent bacteria from reattaching to the teeth, the tooth roots will be smoothed. The process is called scaling and root planing.
After the dental cleaning, the periodontist will place the bone graft material where needed and shape it. Along with the bone graft material, a process called guided tissue regeneration (GTR) may also be used. It involves using a specially treated mesh, usually with growth factors, which aids healing and prevents other tissue from mixing with it.
Recovery and Healing
Depending on the severity of the bone loss from periodontitis, the process can often be completed in 45 to 90 minutes. Patients can expect their gums to heal within two weeks. The bone graft, however, will need between three to six months to heal, and some may take longer. This will depend on:
- The bone material used
- The procedure used and the complexity
- How well the patient follows instructions
- The location of the graft – upper or lower jaw.
There should be very little pain after the surgery, but a little soreness may be expected. Over-the-counter pain medications should be sufficient. Antibiotics may also be given to help prevent infection. An ice pack may be used to help with swelling if present.
Qualifications for Candidates
Bone grafts can be used in many types of problems. They are used to prepare the jaw to replace missing teeth, to repair trauma to the jaw, and to reconstruct the jaw after a tumor or cyst has been removed. Candidates need to be free from problems such as diabetes, which can hinder or slow healing. The bone that will be around the bone graft needs to be healthy and have a sufficient number of osteoblasts present because this is what will produce the new bone material.