Bone Grafting in Dentistry
Bone grafting is a broad term describing a procedure where a substance or mixture is placed in direct contact with live bone with the goal of new bone formation. At our Kitchener Dental Clinic, we discuss the placement of graft material following tooth extraction to minimize bone and gum tissue loss that results when an extraction socket is left untreated. This is a specific bone grafting procedure called “Socket Preservation”. Socket preservation is an inexpensive procedure and is covered by many dental insurance plans. The advantages of socket preservation include:
- It maintains gum and bone tissue levels at normal heights
- It minimizes sensitivity in neighbouring teeth due to root exposure from post-extraction gum recession
- It maintains proper cleansability around neighbouring teeth by eliminating post-extraction gum recession
- It preserves the proper width of jaw bone post-healing to enable future dental implant placement
- It maintains proper gum contour and architecture to enable placement of an esthetic and natural looking dental bridge
Oral Surgery in Kitchener: What is involved in having socket preservation completed and how long does it take?
At our Kitchener Dental Clinic, I perform socket preservation grafting immediately following dental extraction. The extraction socket is first thoroughly cleaned and irrigated. Next, bone graft material, which typically has the consistency of a thick putty, is placed directly into the extraction socket. A foam-like membrane or barrier is placed over the graft and the opposing gum segments are sutured to seal the healing site. A dental radiograph is taken to ensure proper graft placement and density. You will receive specific post-operative instructions to ensure proper healing of the socket preservation graft. Typically, graft healing is sufficient after 4-5 months to enable placement of a dental implant. Restoration with a dental bridge can be completed after 3 months healing in most cases.
Socket preservation adds roughly 3-5 minutes to the duration of a dental extraction procedure. Our patients find socket preservation to be a comfortable procedure.
Oral Surgery in Kitchener: Is socket preservation necessary?
Without socket preservation grafting, you will lose a significant amount of bone height and thickness as the extraction site heals and remodels. Here are a few complications that can arise due to post-extraction bone loss:
- Insufficient bone volume to place an implant. You need to have lots of bone anchoring an implant restoration if it is to succeed long-term. Without a socket preservation graft, you will lose bone and this makes future implant therapy at the site difficult.
- Vertical loss of bone requiring a longer bridge tooth. A bridge tooth will have a height that is set so that it looks like it is emerging from your gums like a natural tooth. If the bridge tooth does not contact your gums, you will have a dark space that looks unnatural. It will look like you have a floating tooth. Without socket preservation, you lose bone height and thickness. Now, you will need an abnormally long bridge tooth to extend up to meet the gums at the site of tooth loss. The extra materials and lab work to design a much larger tooth will cost you more. With socket preservation, you preserve normal bone levels and can restore the space with a natural looking bridge tooth.
- Gum recession and sensitivity on teeth neighbouring the extraction site. Bone loss means gum loss. So, after a tooth extraction, gums and bone are lost around teeth adjacent to the treatment site. This can often lead to root exposure and intense cold and hot sensitivity on these neighbouring teeth.
So, we can see that there are huge benefits to socket preservation procedures. However, where you are not planning to replace your lost tooth, the procedure may not have much value to you. And treatment decisions in Dentistry, as in many other realms, should be based on value. So the best practice is to ask your Kitchener Dentist what benefits a socket preservation treatment will have for you!
Oral Surgery in Kitchener: How much does socket preservation cost?
The Ontario Dental Association (ODA) Fee Guide for Family Dentists suggests a fee of approximately $250 for a socket preservation procedure. The Fee Guide also dictates a fee for materials (i.e. the socket graft material). This fee is typically in the range of $75 – $125 depending on the size of the extraction sockets and the volume of graft material used in the procedure. So, a total fee for socket preservation would come in at approximately $350.
Guided Tissue Regeneration
Guided tissue regeneration is a more complex form of bone grafting that is utilized when one or more walls of an extraction socket are broken or lost during extraction. The procedure involves use of similar components compared to socket preservation. The fundamental difference is that a membrane or barrier must be extended over the graft material adjacent to the broken or fractured wall of the extraction socket. This barrier prevents invasion of the bone graft by gum tissue cells which would compromise formation of high-quality bone. Instead, bone tissue cells have unimpeded access to the graft enabling formation of robust, new bone.
Bone Grafting for Dental Implants
Bone grafting can be carried out easily prior to restoration with dental implants. Grafts will increase bone volume in and around dental extraction sites. This provides adequate bone to support the dental implant screw and to support nicely contoured gum tissues around your implant crown. Ideally, bone grafting is completed at the time of tooth extraction but may also be completed years after the extraction in many cases.
Bone Grafting Materials
Materials for bone grafting vary. Generally, there are 3 categories:
- Autogenous Grafts: An autogenous graft is compromised of a patient’s own bone harvested from a donor site on their own body. These grafts are uncommon and only used when a large volume or block is required to rebuild the jaw.
- Xenografts: This type of graft involves taking bone tissue from an animal or different species. In dentistry, common xenograft substances contain bovine or “cow” bone. This type of graft is widely used in Dentistry to improve bone volume prior to placement of dental implants. It is also used to treat periodontal bone defects between teeth in some cases.
- Synthetic Grafts: This type of graft is also very common in Dentistry and involves use of a synthetic mixture of substances that promote your body’s ability to build new bone. Synthetic grafts are ideal for individuals that prefer to avoid the use of bone material from other species.
Bone Grafting Doesn’t Have to be Complicated
You don’t necessarily need a referral to have routine grafting and socket preservation completed. Some Dentists complete additional surgical training to provide these services directly to their patients. Having a Family Dentist in Kitchener that provides bone grafting, socket preservation, and guided tissue regeneration simplifies the restorative process while eliminating extra referrals and appointment time and this minimizes your fee burden. Call our Kitchener Dental Clinic today at (519) 576-8160 to book a consult with Kitchener Dentist, Dr. Hornby, regarding bone grafting and advanced restorative procedures.