Dental bone grafting: when to do it? What is it? What are the risks and complications? How does a dental bone graft procedure work? What are the different types of grafts? And finally, what can be done to relieve the pain after a dental bone graft?
I. What Do I Need to Know About Dental Bone Grafting?
Dental bone grafting is a dental procedure that is performed to facilitate the implantation of a new tooth.
To strengthen the bones already present in a jaw, it may be necessary to add bone to solidify the bone base.
This can be done using autologous bone or artificial bone to fill in the gum spaces.
A radiological assessment is necessary before the decision to perform a bone graft is made.
II. When Is a Dental Bone Graft Performed?
Dental bone grafting is performed before a dental placement. It is a procedure that takes place when there is not enough bone in the jaw to allow for a successful dental implant.
There are several reasons for this lack of bone material. For example, there are genetic causes for tooth loss.
Tooth extractions or periodontal disease may also require bone grafting before dental implantation.
Another cause is toothlessness that has not been properly treated and has persisted.
III. Dental Bone Grafting: Risks and Complications?
There are nevertheless risks of dental bone grafting.
# Infection:
Infection is one of the greatest dangers of dental bone grafting. It can occur at several levels.
It is possible to develop an infection after contracting postoperative sinusitis.
Infection can also develop because of the healing time. If the healing time is too long, it will allow time for bacteria to grow.
# Wound Opening:
Although rare, wound opening is one of the risks of a dental bone graft. This can happen if the sutures did not hold, especially if they were badly made.
The graft area can then open up and become a wound.
# Difficulty in Healing the Gum:
After a dental bone graft, the gums need time to heal. Normally, it takes between 8 and 15 days for the healing to take place.
This remains a delicate period, during which the gums are exposed and sensitive. Bacteria and infections are then a great danger.
# Risk of Graft Failure:
It can happen that a dental bone graft does not take. This can happen shortly after the operation or later.
The risk of graft rejection is lower when the graft comes from the donor’s own body.
In these cases, the biological and genetic compatibility favors the success of the transplant. However, bone grafts often use artificial materials or materials from animals.
In these cases, the rejection of the graft is a real risk and a danger to the health of the graft recipient.
# Risk of Sinusitis:
Sinusitis is the most common risk after dental bone grafting.
This happens if, for example, the grafted material moves into the sinus. Sneezing promotes this kind of movement.
For this reason, it is advisable to avoid allergens as much as possible right after a dental bone graft.
There are several manifestations of a sinus infection. Swelling, pain, nasal obstruction, or the appearance of a mass on the palate or in the nostrils are all signs of a sinus infection.
IV. How Does a Dental Bone Graft Procedure Work?
The dental bone grafting procedure follows several steps.
First, it always begins with a preliminary examination. An X-ray is performed to determine exactly how much bone is needed for the implant.
The bone can be taken from the jaw, hip, or skull; or it can be artificial or from animals.
The surgeon will then decide whether to use the graft in pieces or to grind it up first. To insert the bone into the jaw, an incision is made in the gum.
It is important to know that the procedure of the bone graft is done on a case-by-case basis. However, in general, the bone is cut until it has the ideal shape for the bone addition.
The graft is inserted, taking care to avoid soft tissue. The soft tissue is pushed away during the operation.
After that, the incision is closed.
V. What Are the Different Types of Grafts?
There are four different types of grafts.
- Allogenic grafts are those that come from BioBANK, which is a bone bank. The bones available are particularly dedicated to bone grafts. These bones allow the natural mechanical movements of the bones to be reconstituted.
- Autogenous grafts are derived from the patient himself. The bone can be taken from the hip or the skull.
- Xenogenic grafts are derived from an animal. Bovine bones are generally used for xenogenic bone grafts. Since the compatibility with the human body is not ideal, these grafts are increasingly replaced by alloplastic or allogenic grafts.
- Synthetic or alloplastic grafts are manufactured in the laboratory. These grafts are made with great care and with strict respect for hygiene to play the role of natural gum bones.
IV. Are There Any Risks Associated with Bone Substitutes Used as Grafts?
No surgery is without risk. In the case of a bone graft, there is a risk of infection or hematoma where the graft was made.
The risk of rejection is also possible, especially in the case of a xenogenic graft.
V. Does a Dental Bone Graft Hurt?
It is possible to experience the pain of varying intensity after a bone graft. The pain may be moderate for some and more intense for others.
VI. What Can Be Done to Relieve the Pain after a Dental Bone Graft?
Pain medication is prescribed for pain after dental bone grafting. Follow the doctor’s treatment. But beyond medication, you can use certain tricks.
For 36 hours after the operation, you can put an ice pack on the cheek at the site of the graft. Do this for 15 minutes.
VII. Healing Time of a Dental Bone Graft?
The healing time after a dental bone graft is between 8 and 15 days. But depending on the case, or the patient (age, state of health…) this time can be more or less long.
VIII. What Is the Dental Bone Graft Cost?
The price of a dental bone graft varies from one institute to another, and from one patient to another.
It is usually estimated that the price of a dental bone graft varies between $600 and $2000. On average, however, the cost of the operation is around $1,500.
IX. How Does a Dental Bone Graft Rejection Manifest Itself?
Several factors can lead to the rejection of a dental bone graft.
We can mention a pain in the gums. This can be accompanied by gum retraction, as well as pain during chewing.
Spontaneous bleeding or bleeding during brushing may also occur.
X. How Can I Avoid a Dental Bone Graft?
If the entire jaw is treated, or a large part of it, it is possible to avoid a dental bone graft.
If you have a fixed prosthesis on a basal implant, you can also avoid bone grafting. This prosthesis is based on the principle of distributing the chewing forces throughout the mouth.
XI. What to Eat After a Dental Bone Graft?
After a bone grafting operation, you should pay special attention to your diet.
Avoid foods that are too hard, too acidic, too salty, or too hot.
Choose vegetable soups. You can also turn to yogurts and fresh products.
Alcohol should be avoided, as it is detrimental to healing.
X. Dental Bone Graft Success Rate
According to a study, composite bone grafts have a survival rate of 99.6% and a success rate of over 65%. Blood derivatives have a survival rate of 97.8% and a success rate of 96.6%. Block grafts have a 98.9% survival rate and a 99.05% success rate. Allografts have a 90.9% survival rate and 82.8% success rate. And particulate grafts have a 100% survival rate and more than 65% success rate.
Useful Links:
Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments
Bone grafts utilized in dentistry: an analysis of patients’ preferences