Bone & Gum Grafting
Seattle Prosthodontics, Dental Implants & General Dentistry • Seattle, WA
When recession of the gingival (gum) tissue occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, reconstruction using grafting techniques becomes the best option. If there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the attached mucosa, the first line of defense against bacterial access is lost.
Concurrently, gum recession often results in root sensitivity to hot and cold foods as well as a possible unsightly appearance of the gum and tooth depending on the location. When significant, gum recession can predispose to worsening recession and expose the root surface which is softer than enamel, leading to root caries and gouging (a notch in the exposed root along the gum line).
What is bone grafting?
Over a period of time, the jawbone associated with missing teeth atrophies and is resorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for the placement of a dental implant. For patients experiencing lack of bone, an implant cannot be placed with a 100% success rate.
In order to become a candidate for an implant, it will be necessary to replace the missing bone either at the time of the surgery or prior, depending on each patient’s situation. Bone grafting allows for successful implant placement with the proper length and width needed, as well as the opportunity to restore functionality and an aesthetic appearance.
Types of Bone Grafts:
Autogenous bone grafts, also known as autografts, are made from your own bone. During extraction and implant placement, Dr. Goll uses a special instrument that saves some of your own bone while he is drilling the space where the implant will be placed. He will then use this material before using xenogenic bone.
Xenogenic and allogenic bone are derived from non-living bone from either a human cadaver or animal (usually a cow or pig). For xenogenic bone, it is processed at very high temperatures to avoid the potential for immune rejection and contamination. Similar to allogenic grafting, xenogenic grafts serve as a framework for bone from the surrounding area to grow and fill the void. Allogenic bone, unlike autogenous bone, cannot produce new bone on its own. Once the bone is extracted, it is processed using a freeze-dried method to extract the water via a vacuum.
The advantage of autogenous grafting is that it has its own bone-forming properties, thus healing is usually expedited. Allogenic and xenogenic grafting while necessary in certain instances, may take longer to regenerate.
Bone graft substitutes: Ridge Augmentation
Ridge augmentation is a common dental procedure performed most often following a tooth extraction to help recreate the natural contour (shape) of the gums and jaw that may have lost its natural structure due to bone loss from recession, trauma or another dentally-related problem.
The alveolar ridge of the jaw is the bone that surrounds the roots of teeth. When a tooth or teeth are removed, the empty socket is left in the alveolar ridge bone. Usually, the socket heals on its own, filling the empty space with bone and tissue. However, there are some instances when after the removal of the tooth, the bone surrounding the socket breaks and is unable to heal on its own. Without augmentation, the height and width of the socket will continue to deteriorate.
While rebuilding the original height and width of the alveolar ridge is not medically necessary, it may be required for implant patients or aesthetic purposes. In the case of patients receiving full mouth extractions or multiple extractions followed by a temporary denture or partial, this procedure is not necessary. Yet, as mentioned before, a successful dental implant requires adequate bone to support the structure and therefore, ridge augmentation can help rebuild this bone to accommodate the implant.