Bone Grafting Spring TX

Major & Minor Bone Grafting

Missing teeth over a period of time can cause your jawbone to atrophy, or resorb. This often results in poor quality and quantity of bone suitable for the placement of dental implants as well as long term shifting of remaining teeth and changes to the facial structure. Most patients, in these situations, are not candidates for dental implants.

Fortunately, today we have the ability to grow bone where it is needed. This not only gives us the opportunity to place implants of proper length and width, but it also gives us a chance to restore functionality and aesthetic appearance.

Major Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum to protect the bone graft, as well as encourage bone regeneration. This is called guided bone regeneration, or guided tissue regeneration.

Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different areas depending on the size needed. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.

The Importance of Teeth for Jawbone Health

When one or more teeth are missing it can lead to bone loss at the site of the gap. This loss of jawbone can develop into additional problems, both with your appearance and your overall health. You may experience pain, problems with your remaining teeth, altered facial appearance, and eventually even the inability to speak and/or eat normally.

In the same way that muscles are maintained through exercise, bone tissue is maintained by use. Natural teeth are embedded in the jawbone and stimulate the jawbone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jawbone that anchors the teeth into the mouth, no longer receives the necessary stimulation it needs and begins to break down, or resorb. The body no longer uses or “needs” the jawbone, so it deteriorates.

Potential Consequences of Tooth and Jawbone Loss

• Problems with remaining teeth, including misalignment, drifting, loosening, and loss
• Collapsed facial profile
• Limited lip support
• Skin wrinkling around the mouth
• Distortion of other facial features
• Jaw (TMJ or temporomandibular joint) pain, facial pain, and headaches
• Difficulty speaking and communicating
• Inadequate nutrition as a result of the inability to chew properly and painlessly
• Sinus expansion

Reasons for Jawbone Loss and Deterioration

The following are the most common causes for jawbone deterioration and loss that may require a bone grafting procedure:

Tooth Extractions
When an adult tooth is removed without replacement, jawbone deterioration can occur. Teeth stimulate the jawbone during activities like chewing, and when missing, the bone resorbs over time. Most bone loss happens in the first 18 months after extraction, continuing gradually throughout life.

Periodontal Disease
Periodontal disease is an infection of the gums that destroys tooth support structures. It begins as gingivitis, caused by plaque buildup, leading to inflamed gums. If untreated, it can progress to periodontitis, damaging the gums and bone, and possibly causing tooth loss.

Dentures/Bridgework
Unanchored dentures don’t stimulate the underlying bone, leading to bone resorption and loosening dentures. Some dentures use anchors that help preserve bone. Bridgework can cause bone loss in the gap area since it doesn’t stimulate the bone there. Bone grafting can restore lost bone and function.

Trauma
Tooth loss or injury can stop bone stimulation, leading to jawbone deterioration. Trauma, like broken teeth or jaw fractures, may require bone grafts to restore lost bone and function.

Misalignment
Teeth misalignment or unopposed teeth can cause bone loss due to lack of stimulation. Conditions like TMJ can also interfere with normal chewing, leading to bone deterioration.

Osteomyelitis
Osteomyelitis is a bacterial bone infection that reduces blood supply to the jaw, causing inflammation and bone loss. Treatment may require antibiotics and bone grafting.

Tumors
Benign and malignant tumors may require jawbone removal. Reconstruction with bone grafting is often needed to restore normal jaw function.

Developmental Deformities
Some conditions lead to missing portions of teeth or bone. Bone grafting can restore bone function in such cases.

Sinus Deficiencies
After molar removal in the upper jaw, bone resorption can occur, often resulting in insufficient bone for implants. A sinus lift can treat this condition by restoring the bone and preventing further deterioration.

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 skull. Autogenous bone grafts are advantageous in that the graft material is your own live bone, meaning it contains living cellular elements that enhance bone growth, also eliminating the risk of your body rejecting the graft material since it comes from you.

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 recommended.

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 the 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 have the advantage of not requiring 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, and have a less predictable outcome.

Bone Graft Substitutes

As a substitute to using real bone many synthetic materials are available as safe and proven alternatives, including:

Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA)

This product is processed allograft bone, containing collagen, proteins, and growth factors that are extracted from the allograft bone. It is available in the form of powder, putty, chips, or gel that can be injected through a syringe.

Graft Composites

Graft composites consist of other bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include: a collagen/ceramic composite, which closely resembles the composition of natural bone, DBM combined with bone marrow cells, which aid in the growth of new bone, or a collagen/ceramic/autograft composite.

Bone Morphogenetic Proteins

Bone morphogenetic proteins (BMPs) are proteins naturally produced in the body that promote and regulate bone formation and healing.

Synthetic materials also have the advantage of not requiring a second procedure to harvest bone, reducing risk and pain. Each bone grafting option has its own risks and benefits. Dr. Sitters will determine which type of bone graft material is best suited to your particular needs.