Bone addition is a surgical procedure used to replace lost bone and stimulate the formation of new bone. The purpose of bone addition is to provide a solid base for dental implants, enlarge areas of insufficient or missing bone and, as mentioned above, facilitate the growth of new bone. In most cases, this bone augmentation procedure is performed to meet the conditions for the insertion of dental implants. The bone graft functions as a framework for the adjacent natural bone stimulating its growth. Several months after the bone addition, the patient's bone will replace the addition material, which is eventually broken down and resorbed by the body.
Bone addition?
When is bone addition/bone augmentation necessary and what does it involve?
There are several reasons why bone loss occurs. The most common reasons include:
- periodontal disease (gum disease): periodontal diseases affect both gum and bone tissue, and teeth become mobile and unstable
- traumatic dental extractions
- untreated dental infections in the oral cavity can cause bone loss
- teeth missing from the oral cavity for a long time without being replaced.
If you are interested in dental implant treatment and your jawbone is not thick enough or is too soft, you may need bone grafting/addition before the actual dental implant insertion procedure. This is because the strong chewing action puts a lot of pressure on the bone, and if it is not strong enough to support the implant, the procedure may fail. Additional bone addition (bone grafting) can create a stronger base for the implant.
It may take several months for the transplanted bone to grow enough new bone to support a dental implant. In some cases, you may only need a minor bone graft, which can be done at the same time as implant surgery. The condition of your jawbone determines how you proceed.
What to expect post-op?
Recovery after surgery depends on several factors: the particular characteristics of the case, the surgical method used, the materials that are used, the experience of the surgeon and the complexity of the operation. On average, healing takes up to 10 days. For faster and more effective healing, you should strictly follow the specialist's recommendations.
During the first 24 hours after surgery, you should only eat soft foods and drink room temperature fluids. During the first week after the operation, smoking, chewing hard food, strenuous physical exertion, hot baths and even the use of mouthwash are prohibited. If necessary, a cold compress can be applied to the face. The cold compress may reduce swelling/swelling. It is absolutely normal for small pieces of the graft to be dislocated. If this happens, you will feel them as small, hard granules in the oral cavity. This is not a cause for concern - most of the graft material will remain where it was implanted.
Avoid any mechanical trauma to the affected area. Carefully brush the teeth near the affected area. In addition to painkillers, your doctor will prescribe antibiotics to avoid possible post-operative infections. The effectiveness of dental implants depends a lot on the quality of the bone graft healing.
Post-op risks
As a rule, after bone addition surgery, you are likely to experience short-term pain in the affected area. Swelling and pain are absolutely normal phenomena, but like slight bleeding and a slight increase in body temperature, it should/is not normal for it to persist for more than 2-3 days.
Bone augmentation is a safe dental procedure and has a low level of risk. However, there are certain risks that every patient should be aware of, may occur:
- infection of the wound and surrounding tissues. In this situation, the patient may experience: severe pain; significant swelling; redness of the gums; purulent discharge; fever. Consultation with a doctor should be immediate.
- heavy bleeding
- complications of anaesthesia
- body rejecting the bone graft
- membrane exposure
- acute or purulent sinusitis.
We warn patients who suffer from diabetes and/or smoke that these diseases/habits increase the postoperative risks to some extent. Other increased risk factors would be old age and other medical conditions.
Materials used for bone addition/bone graft
Autograft or autologous graft
Graft harvested from the patient. An autograft uses bone taken from elsewhere in the patient's body. Typical sites include the leg, hip, chin or jaw. Although this requires an additional surgical procedure to harvest the bone, it eliminates the risk of rejection or any other adverse reactions. Also, the harvested bone is alive, which means it has certain cellular elements that will help increase the production of new bone.
Allograft or graft collected from donor
Bones from a genetically similar organism. An allograft uses highly processed bone taken from a donor that can be dried and frozen, irradiated or chemically treated to ensure its safety. It is extensively tested to eliminate the risk of contamination. Like xenograft, allograft will support your body to grow new bone cells, but it cannot produce new cells on its own.
Xenograft or graft of animal origin
For many years the most widely used xenograft has been bovine bone. It is sterilised and processed to minimise infection. The graft is placed to act as a 'biological space maintainer'. Initially, it mechanically prevents the collapse of surrounding tissues, whether bone or soft tissue. Then, through a process called 'guided tissue regeneration', the human body is biochemically tricked into recognising the graft as natural bone and over time it resorbed and replaced it with its own bone.
Alloplastic or artificial graft
Made of biocompatible synthetic material, the alloplastic graft is a graft made of fully synthetic materials. Synthetic bone graft materials are highly sophisticated and contain a variety of different substances. They may have a combination of collagen, proteins and growth factors, which are designed to help promote the formation of new bone cells and promote healing.
Bone addition can also be achieved with the help of a special membrane, which is needed to isolate the added bone material from the soft tissues. This is placed over the addition material and creates a uniform contour for the formation of the alveolar ridge. Two types of membrane are used:
- resorbable: which will be assimilated by the body and therefore do not require a removal procedure
- non-absorbable: made of titanium, to be removed 3-9 months after installation.