Bone grafting
Understanding dental bone grafts
What a dental bone graft is, the types of graft material, what happens during the procedure, how long healing takes, and what to avoid afterward.
What Is a Dental Bone Graft?
A dental bone graft is a type of oral surgery that adds bone grafting material to the jaw where bone has been lost or has thinned, and Cleveland Clinic describes it as increasing the volume and density of the jaw. The material can be natural or lab-made, and it is usually placed as a powder.
The graft works like a scaffold. It holds space in the jaw so your own bone tissue can grow into it and regenerate. Dentists and specialists such as oral surgeons and periodontists do bone grafts routinely, most often before dental implant surgery or when bone loss is affecting oral health.
Why Might You Need a Bone Graft?
You might need a bone graft when there is not enough jawbone to hold a dental implant or support other restorative treatment. The American Academy of Periodontology lists periodontal disease, wearing dentures, developmental defects, injury and trauma as causes of that kind of bone defect.
A dental bone graft can be used to:
- Fill an empty tooth socket after an extraction
- Increase the width and volume of the jawbone
- Lift the maxillary sinuses, which is needed before dental implants in some situations
- Give dental implants a strong foundation
- Rebuild the jaw before dentures
- Repair bone damaged by dental trauma
- Stabilize and support loose teeth
- Treat bone loss caused by infections such as gum disease
What Types of Bone Graft Material Are Used?
The four types of bone graft material Cleveland Clinic describes are autogenous bone, allograft, alloplast and xenograft. They differ in where the material comes from, and your dentist explains which one fits your case after examining the site.
- Autogenous bone graft: your own bone, taken from another area of your body
- Allograft: human bone from a licensed donor bank
- Alloplast: a lab-made bone substitute, such as hydroxyapatite, a naturally occurring mineral
- Xenograft: animal-derived bone from a licensed donor bank, most often cow (bovine) or pig (porcine) bone
What Happens During a Bone Graft Procedure?
During a bone graft procedure, Cleveland Clinic explains, the gums are numbed with local anesthetic, a small incision is made, and the grafting material is added where bone is missing. Exact steps depend on where the graft goes. The usual order is:
- Numbing the gums with local anesthetic, plus sedation if you have chosen it
- Making an incision in the gums and gently moving them away from the jawbone
- Cleaning and disinfecting the area
- Adding bone grafting material to the areas of bone loss
- Covering the graft with a protective membrane; many dissolve on their own, others are removed at a follow-up visit
- Repositioning the gums and closing the incision with stitches
How Long Does a Bone Graft Take to Heal?
A dental bone graft takes about a week for initial recovery and at least three months for the graft itself to heal, according to Cleveland Clinic. A large graft may take nine to 12 months. Tenderness, swelling and bruising are normal at first and should go away within a week or two.
The American Academy of Periodontology gives a slightly different range for grafts that build up the jaw ridge: the bone usually develops for four to 12 months before implants are placed.
How Soon Can You Get an Implant After a Bone Graft?
A dental implant is best placed within six to 12 months after a bone graft has healed, Cleveland Clinic advises. A graft that is not used starts to shrink and lose density, so the timing of the graft and the implant is planned together.
In some cases the implant can be placed at the same time as the graft.
What Should You Avoid After a Bone Graft?
After a bone graft, Cleveland Clinic advises avoiding anything that disturbs the surgical site, including vigorous spitting or swishing, smoking and vaping. Your dentist gives you instructions for your own case, and those come first. The general guidance is:
- Do not drink alcohol for at least two weeks
- Do not exercise or lift anything heavy for at least 48 hours
- Do not smoke or vape
- Do eat soft foods for a few days
- Do use ice packs on the outer jaw and keep your head raised to reduce swelling
- Do keep the site clean and take every medication as prescribed
When Should You Call About a Bone Graft?
Call your dentist about a bone graft if you develop a fever of 101 degrees Fahrenheit (38.3 degrees Celsius) or higher, increasing swelling, pus around the graft site, or severe pain, which are the signs Cleveland Clinic lists. Smoking and certain medical conditions raise the chance that a graft fails.
Other signs a graft may be failing are pain or swelling that gets worse after the first week, drainage from the site, gum recession, and no improvement in jawbone volume. Our office number is (661) 255-1211.
Bone Grafting at Smile Care Valencia
At Smile Care Valencia, Dr. Robert P. Hedvat does bone grafting and places dental implants, so the graft and the implant that follows are planned by the same dentist. Our in-office 3D cone beam CT scanner gives a detailed view of teeth, jawbone, sinuses and nearby nerves, and is used to evaluate complex concerns and plan implant treatment with greater precision.
If you feel anxious about surgery, ask about sedation options, including nitrous oxide, twilight sedation where appropriate, and IV sedation under the care of a Dental Anesthesiologist.
Common questions
Bone Grafting Questions
How painful is bone grafting for teeth?
Bone grafting for teeth is a relatively minor procedure, and most people who have one report little to no pain, according to Cleveland Clinic. The gums are numbed with local anesthetic first. Afterward, tenderness and swelling are normal for a week or two and can usually be managed with over-the-counter pain relievers.
Will gums grow over a bone graft?
The gums are placed back over a bone graft during the procedure. After the material is added and covered with a protective membrane, the gums are repositioned and the incision is closed with stitches, so the graft heals underneath them.
What is the downside of a bone graft?
The downside of a bone graft is the same as for any surgery: it carries risks, including anesthesia complications, infection, nerve damage and severe bleeding. It adds healing time before an implant, usually at least three months, and grafts are more likely to fail in people who smoke or have certain medical conditions.
Is it normal to lose small grains after a bone graft?
Losing small bone fragments in the first few days after a bone graft is normal. They look like grains of sand or salt and usually are not a cause for concern. If you lose a large amount, let your dentist know.
How long does a dental bone graft last?
A dental bone graft can last a lifetime once it heals, but bone that is not used shrinks. That is why an implant planned for a grafted site is best placed within six to 12 months after the graft heals.