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Bone Grafting

Bone Grafting

bone grafting pasadenaIn 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.

Who will benefit from a bone grafting treatment?

Dental bone grafting is necessary in situations where bone volume has been diminished by trauma, infections or periodontal disease. Sometimes the treatment may also be recommended to correct damage caused by removable dentures.

What is the primary purpose of Dental Bone Graft Surgery?

One of the most common purposes of dental bone grafting is to strengthen the bones’ structure preceding a dental implant as a dental implant needs sufficient support in which to be anchored. In some cases dental bone grafts may also be required to ensure bone strength where the bone might be in danger of breaking, for example, through tooth extraction.

Where does the grafting material come from?

It can come from a variety of sources, including your own body. These days, however, laboratory-processed bone from a human or animal donor (usually a cow), as well as synthetic materials, are frequently used.

Is it safe?

There are no safety concerns with grafting material that come from your own body. However, this method does have a disadvantage in that it involves creating a second surgical site — the place from which the bone is obtained. Mineral bone substitutes, whether they are coming from human donor bone or animal bone, pose little risk of infectious disease transmission as they undergo meticulous safety screening. Both have a similar level of risk, due to the extensive and rigorous processing the material undergoes at the highly reputable tissue banks used. This results in graft materials that have proven to be extremely safe. Also, you may be interested to know that mineral graft materials do not remain in the body but are naturally absorbed and replaced by your own bone over time.

Does the procedure hurt?

Bone grafting involves a small incision in the gum to gain access to the bone beneath it. Therefore, you may experience some post-operative soreness. Most people find this can be managed with ice packs applied to the jaw and over-the-counter anti-inflammatory medication and/or pain relievers.

How long does it take to heal?

You should feel back to normal in a day or two. But at this point the bone-regeneration process will have only just begun. Over the next several months your body will continue to deposit new bone cells and remove the grafting material.

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

 

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