Bone Grafting

In order to optimize comfort, function and esthetics, bone grafting is required to replace missing bony tissue, and in many cases support the placement of dental implants.

Bone grafting is a procedure where bone is transferred from one area or location and placed into a new location. The oral and maxillofacial surgeon can therefore “build bone” in areas where it is missing. In the practice of oral and maxillofacial surgery, the need for bone grafting presents itself in a multitude of situations.

Types of Bone Grafts

• Autogenous Bone Grafts:
  Autogenous bone grafts, also known as autografts, are made from your own bone, taken from somewhere else in the body. The bone is typically harvested from the chin, jaw, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is live bone, meaning it contains living cellular elements that enhance bone growth.

However, one downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on your condition, a second procedure may not be in your best interest.

• Allogenic Bone:
  Allogenic bone, or allograft, is dead bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on it’s own. Rather, it serves as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the defect or void.

• Xenogenic Bone:
  Xenogenic bone is derived from non-living bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenogenic grafts serve as a framework for bone from the surrounding area to grow and fill the void.

Both allogenic and xenogenic bone grafting are advantageous in that they do not require a second procedure to harvest your own bone, as with autografts. However, because these options lack autograft’s bone-forming properties, bone regeneration may take longer than with autografts, with a less predictable outcome.

Diagnosing Bone Loss

PostOp Instructions: Bone Grafting

Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. The socket is over packed to allow for the loss of a small amount of particles. It is normal to have some of them come out of the graft site and into your mouth. There are some things that can be done to minimize the amount of particles that become dislodged.

What to expect following surgery:

• BLEEDING: Small amounts of blood in the saliva can make your saliva appear quite red/pink the remainder of the day after the procedure.
• PAIN: Before the anesthetic wears off it is recommended that you fill your prescriptions given to you at the time of the surgery. If more severe discomfort occurs please contact the office 626-304-3004.
• SWELLLING: Some swelling of the lip or cheek may occur. What to do following surgery: After leaving the office, rest and avoid strenuous activities for the remainder of the day. This will help reduce bleeding and aid in the healing process. Take your meds as described above. Be sure to take before the anesthesia wears off.

Nausea can occur and most often is due to taking your meds on an empty stomach. Take your meds with a large glass of water or with some soft food. Eat soft foods for the first 2-4 days. Maintain a good, balanced diet.

Drink plenty of water. Avoid chewing hard foods on the graft sites. Chewing forces during the healing phase can decrease the body’s ability to heal around the graft.

Do not use a straw.

Avoid alcohol for 48 hours. For the first day, it is advisable to let the blood clot stabilize by not rinsing your mouth. Following the first day, gentle rinsing would be advised; avoid vigorous rinsing.

Do not rinse vigorously because you can disturb some of the bone graft granules. Do not use any mouthwash. Use only water or warm salt water if desired. Smoking should be avoided for a minimum of 1 week as it slows down the healing process.

Do not apply pressure with your tongue or fingers to the grafted area because the material is movable during the initial healing.

Do not lift or pull the lip to look at the sutures as this can actually damage the site or tear the sutures and cause damage to the wound site. Avoid poking the site with your tongue.

Do not avoid cleaning the area. You can take a q-tip and dip it in hydrogen peroxide or just water and gently clean the site.

Do not avoid brushing your teeth but stay away from the site with the toothbrush.

Let comfort be your guide. Please call the office if you have: Uncontrollable pain – Excessive or severe bleeding – Marked Fever – Excessive warm swelling. Or if you have any other questions or concerns please contact our office at (626)304-3004