BONE GRAFT
WHAT IS A BONE GRAFT?
If you are missing teeth in the upper or lower jaw, you may choose to replace these with dental implants. The success of a dental implant is partly based on the amount of bone in this region. If you have enough bone, you will not need a bone graft. However, loss of teeth in this region may, over time, cause bone loss.
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A bone graft is a surgical procedure that is performed to increase the amount of bone in the area of the missing teeth teeth.
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Bone may be taken from various sites in the mouth including the back of the lower jaw or the chin. This site is known as the donor site.
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Bone from the donor site is then placed into the site where there is not enough bone. This is known as the recipient site.
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The recipient site is then left to heal for 3 - 6 months before dental implants are placed.
WHAT INVESTIGATIONS WILL I NEED BEFORE MY TREATMENT?
You will need an x-ray before your bone graft.
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A 2D x-ray will show the amount of jaw bone remaining in the recipient site. However, this provides limited information regarding the 3D structure of the bone.
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As such a 3D scan will also be required. The 3D scan will provide greater detail of the shape of the bone in the recipient site and the donor site
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HOW WILL MY BONE GRAFT BE PERFORMED?
Before I perform your bone graft, I will apply numbing injections in the gums around the recipient site and the donor site. I will then leave this for 5 minutes for the anaesthetic to work.
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I will check that the anaesthetic has worked by pressing around both sites using a dental probe. At this point, you will feel pressure but you should not feel pain. If you feel pain, I will leave more time for the anaesthetic to work or apply more anaesthetic depending on what you can feel.
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Your surgery will only start when you are happy that you are numb. The gums around both sites will be opened with a small incision. Once the bone can be seen, bone will be taken from the donor site. This will then be placed in the recipient site. The space between the bone graft and the recipient site may also be filled with bone substitute.
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Once your bone graft has been performed, the opening in the gums will be closed with stitches. The stitches will dissolve 10 - 14 days after your surgery.
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WHAT IS THE BONE SUBSTITUTE USED TO REPLACE THE MISSING BONE?
There are a number of bone substitute used to fill the space between the bone graft and the recipient site.
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Usually this bone substitute is bovine (cow) derived. The bone substitute has all of the mineral content removed from it and is sterilised. As such, no bovine element remains in the bone substitute.
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Your body's own bone cells use this bone substitute as a scaffold upon which to grow and replace the missing bone.
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Bovine-derived bone substitute has a long, well-established track record of safety for use in humans.
WILL I BE AWAKE DURING MY SURGERY?
Bone grafts are performed under local anaesthetic or intravenous conscious sedation.
Treatment under local anaesthesia only numbs the gums around the area to be treated. You will be awake throughout your treatment, but you should not feel any pain or discomfort.
Intravenous conscious sedation is administered through a vein in your arm or hand. However, this is not the same as a general anaesthetic which will put you completely to 'sleep'. Instead, intravenous conscious sedation will reduce your awareness of the procedure. The treating team will still be able to speak with you and identify if you are feeling discomfort.
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During your consultation I will discuss the advantages and disadvantages of treatment under both local anaesthetic and intravenous sedation at greater length.
WHAT WILL MY RECOVERY TIME BE AFTER MY BONE GRAFT?
You may experience pain, swelling and bruising after your bone graft.​
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Pain usually worsens over the first 3 days after surgery. This may take up to a further 10 days to stop, with daily gradual improvements. Provided that you have no allergies, intolerances or reasons why you cannot take them, the following painkillers are advised:
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Paracetamol 1g every 6 hours for 7 days
Ibuprofen 400mg every 8 hours for 7 days
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I will confirm with you which are best in your case.
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Swelling usually worsens over the first 3 days after swelling. This may take up to a further 10 days to disappear, with daily gradual improvements. You may use an ice-pack applied to the outside of the face for 15 minutes in the morning and in the evening to help to reduce the swelling.
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Bruising after a bone graft s common. This will usually resolve with any swelling that you may experience.
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You will also require antibiotics after your surgery, which I will prescribe depending on which is most appropriate.
WHAT CAN I EAT AFTER MY BONE GRAFT?
Immediately after your surgery while you are still numb, avoid hot food and drink to prevent burning yourself without realising.
Once the local anaesthetic has worn off, you will find a soft diet for the first 3 days after surgery more comfortable. If you feel that you can return to a normal diet you may do so.
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Avoid small grains and pieces that may cause trauma to the surgical site for 5 days after your surgery.
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Avoid alcohol for the first 48 hours after your surgery.
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Avoid smoking for at least 72 hours after your surgery - the longer you are able to stop smoking the lower the chances of infection.
CAN I BRUSH MY TEETH AFTER MY BONE GRAFT?
You should return to toothbrushing as soon as possible after your bone graft. Ideally you should start on the same evening as your cyst removal.
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You should resume mouthwashing with mouthwash or saltwater as soon as possible after your bone graft surgery.
DO I NEED A REVIEW AFTER MY BONE GRAFT?
Once your bone graft has been performed, the site will be left for at least 3 months before further treatment.
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Prior to implant placement, your dentist will arrange further review with you. You will also likely require a 3D scan to review the healing in the region before implant placement.
ARE THERE ANY OTHER TREATMENT OPTIONS?
A bone graft is only required if you have insufficient bone in the region of missing teeth and you wish to replace missing teeth in this region with dental implants.
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You may choose to replace missing teeth by other means including dentures or a bridge. Your dentist will discuss all treatment options to replacing teeth before referring you for bone graft surgery.
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