Bone Grafting

Periodontal disease is the leading cause of bone loss in the oral cavity, though there are others such as ill-fitting dentures and facial trauma.  The bone grafting procedure is an excellent way to replace lost bone tissue and encourage natural bone growth.  Bone grafting is a versatile and predictable procedure which fulfills a wide variety of functions.

A bone graft may be required to create a stable base for dental implant placement, to halt the progression of gum disease or to make the smile appear more aesthetically pleasing.

There are several types of dental bone grafts.  The following are the most common:

  • Autogenous bone graft – In this type of graft the bone is removed from elsewhere in the body and implanted in the mouth.  Common donor sites for bone grafting include the iliac section of the pelvis, the chin and the posterior third molar areas of the jaw.  If large amounts of bone need to be harvested, the hip or the shin bone (tibia) is generally used.

  • Allograft – Synthetic bone (man made) can be created in the laboratory and used in the bone grafting procedure.  Bone can also be obtained from a bone bank (cadaver bone).

  • Xenograft – This is the implantation of bovine (cow) bone.  A xenograft is perfectly safe and has been used successfully for many years.  Ample bone can be obtained and no secondary donor site is necessary.

Reasons for bone grafting

There are a wide variety of reasons why bone grafting may be the best option for restoring the jaw bone.

Dental implants – Implants are the preferred replacement method for missing teeth because they restore full functionality to the mouth; however, implants need to be firmly anchored to the jawbone to be effective.  If the jawbone lacks the necessary quality or quantity of bone, bone grafting can strengthen and thicken the implant site.

Sinus lift – A sinus lift entails elevating the sinus membrane and grafting bone onto the sinus floor so that implants can be securely placed.

Ridge augmentation – Ridges in the bone can occur due to trauma, injury, birth defects or severe periodontal disease.  The bone graft is used to fill in the ridge and make the jawbone a uniform shape.

Nerve repositioning - If the inferior alveolar nerve requires movement to allow for the placement of implants, a bone grafting procedure may be required.  The inferior alveolar nerve allows feeling and sensation in the lower chin and lip.

What does bone grafting treatment involve?

Bone grafting is a fairly simple procedure which may be performed under local anesthetic; however if large amounts of bone area need to be grafted, general anesthetic may be required.

Initially, the grafting material needs to either be harvested or prepared for insertion.  A small incision is made in the gum tissue and then gently separated from the bone.  The bone grafting material is then placed at the affected site.

The bone regeneration process may be aided by:

  • Gum/bone tissue regeneration – A thin barrier (membrane) is placed below the gum line over the grafting material.  This barrier creates enough space for healthy tissue to grow and separates the faster growing gum tissue from the slower growing fibers.  This means that bone cells can migrate to the protected area and grow naturally.

  • Tissue stimulating proteins – Enamel matrix proteins occur during natural tooth development.  Emdogain is a matrix protein product which is usually placed on the affected site before the gum is sutured.  It mediates the formation of accellular cementum on the tooth which provides a foundation to allow periodontal attachment to occur.  Tissue stimulating proteins help to create lost support in areas affected by periodontal defects.

  • Platelet-rich growth factors –A high platelet concentration liquid can be used to create a blood clot at the site of a wound.  It has recently been discovered that PRGF also stimulates bone growth – meaning a denser graft in a shorter time period.

The gum is sutured in place and a follow up appointment will need to be made within 10 days to assess progress.  Bone grafting is a highly successful treatment and a good base for further periodontal restorations.

If you have any questions about bone grafting, please ask your dentist.

Testimonials.

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Testimonials

I've had the privilege of going to Dr. Howard since young (decades). Now my entire family has chosen Dr. Howard and Dr. Alan Igasaki as our dentists. Both are calm, soothing, gentle and amazing dentists. Dr. Alan also specializes in periodontics which helped the extensive gum work we had to do over the years. The entire staff is super friendly and fun. There wasn't one visit I didn't leave laughing or encouraged by some one on the staff.

The doctors work well together and often seek each other's opinion. I appreciate that they're always educating themselves and using the latest technology. Dr. Alan used the laser on my son's gum procedure with no bleeding and minimal pain. They also allow you to bring your own music in and can play movies on a special eyeglass video screen. We often didn't want to leave since the "movie wasn't over." I get pretty anxious with any dental work. I watched a relaxing movie about Hawaii and the ocean. Both doctors are soothing and often talk to you a long time previous to treatment. It helps a lot. They're gentle also and will ask you for feedback if there's pain or discomfort. Very empathetic doctors as well as being brilliant clinically is rare. Highly recommended!!!

M D.

I cannot believe I am giving ANY dentist that I have personally seen any stars. But I must say Dr. Howard Igaskai, deserves every single one of them. I am not an easy person to get into a dental office let alone a dental chair! My fear of dentist started as a child & never went away. Dr. Howard aka Papa Howard, knew of my anxiety & went as far as unbuttoning his top collar & removing his coat just to make me feel at ease. I honestly have major trust issues w/dentist. I have horrible teeth due to the lack of dental care. I need a lot of work & it took a lot for me to even make this appointment. With that being said Dr. Howard took his time to explain & examine everything. I have to admit I didn't trust him from the get go & had a stink face but as the appointment went on he made me feel comfortable enough to make me want to return to his office. Yes, you read that right. I will go BACK....WILLINGLY! I'm still afraid & nervous as heck but from the front desk ladies, to the dental assistants & Dr. Howard....thank you! Thank you for NOT giving up on me. Thank you for making me feel comfortable enough to want to return. I'll see you again (still anxious) but I will be there.

Diana A.

I am SO honored to be able to rate and provide information on my dentist's office. In a world where people freak out about seeing the dentist, I LOVE mine! The front staff is great (very welcoming and informative), Elsie is my favorite hygienist (very inviting and great to talk to - even with tools in your mouth!), and Dr. Howard is da bomb! This is the one doctor I see religiously!

My parents were smart in taking me with them to the dentist (they are patients here, as well) when I was very young. I don't recall what age I was when Dr. Howard first started treating me, but I don't ever recall not knowing or feeling comfortable with him. And, now that I'm old, he still asks about my migraines, my family, and is just very pleasant to speak with any time I do.

I wanted to whiten my teeth and he told me no - that mine are naturally bright. He could have done it anyway, but that's just one way he is always looking out for me.

God willing, I will NEVER not have the wonderful folks here as my dental professionals! I always get compliments on my teeth!

Anika C.

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Contact Us. We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.