Bone Grafting

There are four main types of dental bone grafts:

• Socket preservation: These grafts are performed immediately following the extraction of a tooth. The graft material fills in the hole left behind when the tooth is removed and prevents the sides of the socket from collapsing and filling the void. These grafts are sometimes called “ridge preservation” grafts.

• Ridge augmentation: If it’s been a while since a tooth or teeth were removed or lost, the jawbone beneath the empty sockets may have deteriorated and become thinner over time. A ridge augmentation graft adds bone volume to the site to provide a stable base for an implant or other restoration.

• Periodontal bone graft: If you suffer from gum disease, the bone supporting your teeth can erode and cause teeth to become loose. If this happens, a periodontal graft can implant tissue around the teeth, supporting and preventing the tooth from moving in the jaw.

• Sinus lift: In cases where the upper back teeth are missing, the maxillary sinuses can drop into the space formerly occupied by the roots of these teeth, making implants impossible without piercing the sinus membrane. The sinus is lifted back into place during the procedure, and a dental bone graft is performed to provide a foundation for implants.

IBone grafting after wisdom teeth extraction isn’t the norm for most patients. In fact, it’s generally reserved for situations where significant bone loss or jaw weakness has occurred due to the position or impact of the wisdom tooth. The bone grafting procedure involves placing bone material into the extraction site to restore lost bone. For the majority of people, the jawbone heals naturally without any additional procedures. However, in select cases—such as when the surrounding bone has been compromised, when there is loss to the back side of the neighboring second molar,  or when future dental work is anticipated—your oral surgeon may recommend a bone graft to create a solid foundation for long-term oral health.

The bone grafting process starts with an initial consultation, comprehensive examination, and advanced imaging to determine if grafting is needed and to plan the procedure.

When are bone grafts recommended after wisdom teeth removal? Here are three scenarios where bone grafting can be beneficial:

1. Impacted Wisdom Teeth

Though a serious problem, impacted wisdom teeth are not uncommon. The American Association of Oral and Maxillofacial Surgeons reports that 9 out of 10 people have at least one impacted wisdom tooth.

When teeth do not have enough room to erupt and develop normally, they grow horizontally (parallel to the jawbone) and become impacted. This indicates that impacted wisdom teeth cannot break through the gums and fully emerge. Likewise, the adjacent second molar can suffer from overcrowding due to impaction. If the impacted wisdom tooth presses against the second molar, damage to the second molar or infection may occur in that area. An impacted tooth can also cause damage to adjacent teeth and neighboring second molars, sometimes requiring bone grafting to restore support.

Sometimes, the situation is more complicated: an impacted wisdom tooth growing sideways can cause substantial jawbone loss near the neighboring second molar. This loss of bone can weaken the support for the second molar, making it more vulnerable to future dental issues. In these cases, grafting is often indicated after wisdom tooth extraction to help provide adequate jawbone support for the surrounding teeth. If bone loss is left untreated, there is a risk of future complications such as infection, further bone loss, or tooth instability.

Spacing issues in the back of the mouth can cause swelling, infections, discomfort, and damage. If the tissue damage is widespread, a bone graft may be necessary to establish a solid foundation of healthy bone to support the second molar adequately.

If you’re receiving a more minor, particulate graft, the bone material may come from a number of sources, including animal or cadaver bone tissue. In these cases, the donor bone is thoroughly sterilized and cleaned to remove soft tissue and ground into tiny particles resembling sand or salt.

It’s important to note here that the “bone” implanted during a dental graft isn’t a “transplant” because no living tissue is implanted. All that remains after the cleaning of the donor bone is the calcium structure.

Particulate bone grafts are a relatively minor procedure, and some dentists will perform the procedure with just a shot of novocaine, like getting a filling. Most of the time, you will be sedated with nitrous oxide or an oral sedative like lorazepam. After the procedure, providers typically prescribe painkillers to help you stay comfortable during healing.

You’ll probably begin to feel back to normal within a week or two of your bone graft procedure, but full recovery from a graft can take anywhere from three to nine months, depending on the type of graft, its location, and how quickly your body heals itself after sustaining a wound.

While most dental bone grafts are successful, there is a chance that the graft could fail, requiring additional grafts or a reevaluation of your dental health plans. As with any surgical procedure, a dental bone graft carries the risk of infection, bleeding, nerve damage, or complications from anesthesia, but these are relatively rare.

The following is a general timeline of the different stages of dental bone graft healing:

• 1-2 weeks: This initial period involves pain, swelling, and discomfort, which can be managed with medication and ice packs. You’ll likely be on a soft diet and need to be gentle with the surgical site.

• 3-4 months: During this stage, new bone begins to form around the graft material. You may still experience some mild discomfort, but overall, you should feel progressively better.

• 6-9 months or longer: This is the final stage where complete healing and bone integration occur. The grafted area should feel normal, and your Cottleville dentist can assess the success of the procedure and determine if you’re ready for further dental work, like implant placement.

Remember, this is just a general timeline, and individual healing experiences can vary.