Dental implants have revolutionised modern dentistry. They offer an effective way to replace teeth lost to infection, trauma, severe tooth decay, or gum disease. Unlike high-maintenance bridges or dentures, implants are fixed directly to the jawbone, so are a long lasting almost permanent solution. Implants also retard bone loss (by absorbing bite force stresses), create a stronger bite that allows you to eat the foods you love, look completely natural and are comfortable!
Occasionally, especially when teeth are lost and not replaced for some time, the missing bone (where the tooth once was) needs building up in order to support an implant. This bone build up is referred to as a bone graft. But when exactly are bone grafts necessary for dental implants?
What is a bone graft?
The placement of dental implants is a routine event for Specialist surgeons in the field. However, there are many Dentists who will either fail to recognise the need for bone grafting or will be unable to offer the complete treatment needed to ensure successful implant treatment. A Specialist surgeon has the added training and experience to properly consider the condition of your jaw bones and undertake the necessary treatment in a skilled minimally invasive manner. A bone graft can stabilise tissue, add bone mass to your jaw, and enable the implant to sit more securely in your jawbone. If your jawbone has thinned, weakened or deteriorated, the implant will be at increased risk of failing under the pressure exerted from repeated chewing.
A bone graft for dental implants could be pieces of your own bone (which will often come from your chin, the back of your lower jaw, or your shin or hip). If there is insufficient bone in these areas, animal (cow or pig) or freeze-dried human bone may be used. Synthetic bone graft materials are also often used, meaning that rejection risks are lower; these materials will also be of interest to vegans and patients with religious beliefs excluding the use of animal by-products.
What is involved in the procedure?
A typical procedure involves removal of a tooth, implant placement and bone grafting in a single stage. Thus, shortening the overall treatment time and requiring a single recovery stage (rather than 2-3 episodes of recovery).
The procedure is performed either awake (under local anaesthetic) or asleep (day stay procedure in Hospital). Recovery time is usually 1-2 days.
A 3D X-ray (CT, Cone Beam – Medicare rebated) image will be taken of your jaws, which will allow for customised planning (and costing) of the suggested procedures. Your Specialist surgeon will remove the tooth (in multiple pieces to minimise bone loss and shorten the recovery), then thoroughly clean the bony socket, then place the implant directly into the tooth socket. Bone graft is then applied around the implant to fill in the gaps (between the tooth socket and the threads of the implant) to ensure the bone fuses with the
A typical procedure can be performed in a dental surgery or as an outpatient. Before surgery, a 3D X-ray image will be taken of your jawbone, and a local anaesthetic or IV sedation administered to prevent any discomfort. If there is enough bone present to insert the implant but not enough to cover its sides, a small grafting procedure will be undertaken. Your surgeon will thoroughly clean the area and then make an incision through the gum tissue to expose the area requiring the bone graft.
If you are receiving bone from your own body, your surgeon will make a second incision to harvest the healthy bone tissue, and if not, they will source bone tissue externally. It is then placed between the two sections of bone that need to fuse. Your surgeon may make repairs to the surrounding tissue, and the incision site is then closed. For extensive cases (where large changes must be made to the implant area’s size and shape), additional surgery may be required before the implant is inserted several months later.
Grafted bone usually takes around six months to fuse with existing bone, but it has a high success rate as bones aren’t rejected by the body, as with organs.
What are the different types of bone graft?
This is the most common type of bone graft for a dental implant. Its purpose is to protect the alveolar bone and prevent its deterioration. The procedure places new bone directly in the socket where the tooth has been removed. It stabilises the socket as the area heals and provides a firm base for the dental implant.
Block bone graft
The jaw can have defects if it has been subject to a significant injury from an accident or other trauma. In this case, your surgeon will remove a large “block” of bone from the back of your jaw and hold it in place with titanium screws until it bonds with the surrounding bone tissue. Once the tissue and gums heal, dental implants can then be inserted.
Lateral ridge preservation graft
If a patient’s jaw is not wide enough to hold dental implants, human bone may be used to increase the jaw’s width and enable the implant process to continue.
Sinus lift procedure
The upper jaw is typically not stable enough to hold a dental implant on its own. In this case, equine bones (which are similar to human bones) may be used to build a base for dental implants. They promote bone growth in the sinus area and create added support for the sinus cavity.
How much does a bone graft cost?
The cost for an implant procedure can differ significantly between patients, depending on their circumstances. However, a single, straightforward dental implant typically costs between $3000 and $7000. The cost increases if you need a bone graft, multiple implants or a sinus lift. Australian health insurance policies typically don’t include the cost of implants or bone grafts unless you have a high level of “extras” cover.
- 2019, Bone graft for dental implant – is it really needed? Dapto dentists
- 2020, Bone grafting, National Dental Care
- 2020, Dental implant guide: cost, process, risks and more, Smile.com.au