30 Central Park South, Suite 3A, New York, NY
Bone Grafting, Manhattan NY
Please call today to schedule an appointment or with any questions: ☎ Frederick G Hegedus, D.D.S. Oral & Maxillofacial Surgeon Phone Number 212-759-2993
When is a Bone Graft Needed?
After tooth extraction, gum disease or injuries, over a period of time, the jawbone reabsorbs or atrophies. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants without bone grafts because dental implants require bone to support their structure.
In the same way that muscles are maintained through exercise, bone tissue is maintained by use. Natural teeth are embedded within the jawbone, and stimulate the jawbone through activities such as chewing and biting. When an adult tooth is removed and not replaced, the jawbone, or the portion of the jawbone that anchors the teeth, no longer receives the necessary stimulation, and begins to break down, or resorbs. The rate the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals. However, most bone loss occurs within the first eighteen months following the extraction and continues throughout life. The body no longer uses or “needs” the jawbone, or the portion of the jawbone, so it deteriorates.
With bone grafting we now have the ability to not only replace bone where it is missing, but also to generate new bone growth in that location. This not only gives us the opportunity to place implant of proper size, but it also gives us a chance to restore functionality and esthetic appearance.
Common Reasons for Jawbone Loss and Deterioration
The following are the most common causes for jawbone deterioration and bone loss that may require a bone grafting procedure:
- Tooth extractions
- Periodontal disease
- Trauma
- Dentures/Bridgework
- Misalignment of teeth
- Sinus deficiencies
- Bone diseases
- Developmental deformities
Type of Bone Grafts
The bone for grafting is either obtained from a tissue bank or your own bone is taken from a different location (e.g. jaw, hip, tibia, calvarium). Sometimes the combination of bone from tissue bank and your own bone is used. In addition, special membranes may be utilized to protect the bone graft and encourage bone regeneration that dissolve then under the gum. This is called guided bone regeneration or guided tissue regeneration.
Autogenous Bone Grafts (using your own bone):
Autogenous bone grafts, also known as autografts, use your own bone, taken from somewhere else in your body. The bone is typically harvested from the back of the jaw, the chin, leg bone, or hip. Autogenous bone grafts are advantageous in that the graft material is your own live bone, meaning it contains your living cellular elements that enhance bone growth and accelerate healing.
One downside to the autogenous bone graft is that it requires a second surgical site to harvest the bone.
Allogenic Bone (cadaver bone):
Allogenic bone, or allograft, is harvested from a cadaver, then processed. Unlike autogenous bone (using your own bone), allogenic bone does not contain living cellular elements, thus it cannot produce new bone on its own. Rather, it serves as a framework or scaffold over which bone from the surrounding bone can grow to fill the defect.
Xenogenic Bone (bone of another species):
Xenogenic bone is derived from that of another non-living species, usually a cow. The bone is processed. Like allogenic grafts, xenogenic grafts do not contain living cellular elements, thus they cannot produce new bone on their own. Rather, they serve as a framework or scaffold over which bone from the surrounding bone can grow to fill the defect.
Both allogenic and xenogenic bone grafting do not require a second surgical site to harvest bone, like autogenous bone grafting. However, because these options lack living cellular elements, bone regeneration may take longer than with autogenous bone grafting, with a less predictable outcome.
Synthetic Bone Grafting Materials:
As a substitute to using real bone, many synthetic materials are available as safe and proven alternatives. Graft composites consist of bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include: collagen, ceramic, and/or composite, which closely resemble the composition of natural bone.
Each bone grafting option has its own benefits and risks. Dr. Hegedus will discuss with you your needs and personal preferences during your consultation visit.