dental instruments and oral health

When is Bone Grafting Necessary?

A common side effect of long-term, untreated periodontal disease (PD) is bone loss. If this is the case, your dentist may suggest a bone graft. In short, bone grafting is a minorly invasive surgical procedure that helps grow new bone that was destroyed by PD. Depending on your needs, the graft may be taken from another area of your body, a donor, an animal, or made of synthetic materials. The grafting material typically consists of processed bone minerals that help your body create new bone cells over time.

Bone grafts should not be used in patients with active infections or immune deficiencies (e.g. radiation and chemotherapy). Pregnant and/or nursing women are also not candidates for this surgery.

Overview: Gum Disease and Bone Loss

Periodontal disease, or periodontitis, is an advanced form of gum disease that permanently damages the gums, bones, and surrounding tissues. The long-term buildup of plaque and tartar (hardened plaque) initiates periodontitis. The gums become irritated and begin to separate from your teeth, forming deep “periodontal pockets” below the gum line. Over time, plaque and tartar collect in these pockets. If you do not get your teeth cleaned professionally, the disease will eventually result in soft tissue and bone loss. Your body does not naturally grow new bone cells. So, grafts are the only treatment option at this stage.

dental implant being placed in the lower jaw

Bone Grafts and Dental Implants

Bone grafts repair damaged bone and also boost the chances of saving your teeth. Although, if tooth loss occurs due to periodontitis, you’ll need a dental implant placed after the bone graft heals. Implants are artificial teeth that mirror the shape of a screw and bond with your bones. Although, in order to successfully place an implant, you’ll need ample and strong bone to support the implant body.

Types of Bone Grafts

There are four types of grafts used to restore bone lost due to advanced gum disease. Depending on your medical history, the severity of bone loss, and your dentist’s recommendations, treatment options include:

Autograft

An autograft procedure is when a surgeon uses your own bone for the graft. It is usually taken from the back of your jaw or hip bone. Although, this type of graft may not be the best option for some patients. This is because pain at the donor site can be severe and may cause primary challenges for certain people. Typically, periodontists use cadaver, animal, or synthetic grafting material. Only in seriously large defects would a surgeon use a graft from the jaw or hip. An autograft typically costs between $700 to $1000 for a single area.

Allograft

An allograft procedure is when a surgeon sources a bone from a human donor. In other words, the bone graft is transplanted from one person to another with different genetics. If you are not a candidate for an autograft, your oral surgeon may recommend an allograft. This procedure is a safe and more affordable alternative to an autograft. There is a minimal risk for infection with demineralized cadaver bone and is often the go-to graft material of choice for small periodontal defects. Additionally, an allograft is only slightly more expensive than a xenograft. An allograft typically costs between $700 to $1000 for a single area.

Xenograft

A xenograft involves using a bone from an animal, typically a cow. This procedure is relatively successful. Although, it has a lower success rate than an autograft or allograft since the bone comes from a different species. As a result, a xenograft does not stimulate the body’s cells to form bone. It acts as a scaffolding into which your bone naturally grows. In many cases, though, parts of the graft turn into your own bone. A xenograft typically costs between $700 to $1000 for a single area.

Alloplast

An alloplast procedure uses synthetic material consisting of phosphorous, hydroxylapatite, and calcium. This procedure poses no risk for disease transmission and is capable of healing small defects by itself. However, similar to a xenograft, it does not stimulate your body’s cells to form new bone. An alloplast bone graft typically costs between $700-1000 for a single area.

Complications & Risks

In some cases, bone grafts can also result in health complications. This includes:

  • A negative reaction to anesthesia during the procedure.
  • Pain, swelling, and/or inflammation around the donor and grafting site.
  • Bleeding or infection.
  • Injuries affecting your nerves.
  • Your body may reject the bone graft.
  • Your body may reabsorb the graft.