The bone augmentation procedure
For most patients who have experienced major tooth loss and the subsequent bone deterioration, a bone graft or augmentation may be the only option if they wish to repair the damage using dental implants; any jaw bone that has been left without teeth for a long period of time will probably have started to break down under the tissue. The extent of the damage is individual to each person; obviously, if the tooth loss is minimal, then this means the treatment is easier for both dentist and patient. In cases where there is some bone loss that needs repairing, a grafting procedure may be employed to rebuild the structure and make it dense enough to hold the implants for many years. This process involves taking a section of bone either from the chin or another part of the body where the bone is very dense, and relocating it to the jaw; healthy bone transference should bond with the deteriorated sections and create a stronger structure. Let’s take a look at how the procedure is carried out and what the results may be if it is successful.
Is anaesthetic necessary for a bone augmentation?
Anaesthesia is a vital part of this surgical process, whether it be local or general. The type of anaesthetic used relates to the amount of reconstruction required, i.e. how much bone needs to be harvested to repair the jaw adequately. Although anaesthesia does add another element of risk to the proceedings, all types are carefully monitored and used regularly enough to minimise the actual danger that comes with operating on an unconscious or sedated patient. People who have heart problems or breathing difficulties might be turned down for treatment because anaesthesia can complicate things further, especially if they need a lot of bone harvesting from certain parts of their body.
If a large amount of material has to be removed in order to strengthen the jaw, it is a better idea to take it from a substantial bone, such as the hip or upper leg, where there is a lot of mass and healthy tissue. This type of operation would not be carried out under local anaesthetic, the patient would need to be rendered unconscious throughout, due to the higher surgical nature of the procedure. In other circumstances, where the patient does not have dense enough bone in larger parts of their skeletal structure, a synthetic substitute may be used to eliminate the need for more invasive surgery; using bone from the body of the patient creates two surgical sites, which lengthens the amount of time on the operating table and the subsequent recovery period – it also increases the chance of complications due to infection.
How is the grafting procedure carried out?
If the surgeon is taking bone from another area of the patient’s body, they will make a small incision into the skin and expose the bone for harvesting, then using a small cutting tool, they will remove a tiny section of the tissue and close the wound with stitches. Most dentist will aim to take bone from another area of the face, to makes sure the tissue is a perfect match, so if they have harvested from the chin, for example, it will be necessary to place a thin film over the surgical site; this is to prevent soft tissue from growing into the gap and compromising the structure – the bone needs to grow back properly.
The section that has been cut away will then be attached to what is left of the jaw bone with titanium screws; this fixes it firmly and encourages as much bone growth as possible by keeping them in constant contact. Titanium is the ideal metal for this job; it is very strong and it has a high resistance to bacteria, which means it won’t succumb to infection easily – it is also known to bond well with living human tissue. If there has been significant deterioration, the surgeon might chose to place extra fragments of bone or marrow around the edges of the graft to pack it together tightly and to encourage a strong bond with which to support the implants. When the material has been successfully transferred, an antibacterial membrane is placed over the graft to protect it from infection and to allow it to grow into a dense structure around the titanium roots once they are placed. The wound is then stitched closed with stitches and appropriately bandaged.
This procedure does sound very invasive but you should know that it doesn’t actually leave a noticeable scar or any obvious signs that surgery has been performed – other than perhaps a slight improvement in the shape of the jaw from outside. There is also a very high success rate with this kind of treatment, primarily because it is really quite simple in application and it relies on the body’s natural ability to bond with new materials, manmade or natural. However, you should be aware that there is a very small chance or rejection, even when the graft has been taken from the patient’s own body; unfortunately, there is no medical reason for this kind of operation to fail, but it should give you peace of mind to know that it is not common at all and it’s highly unlikely that this will happen to you at any point. As a point of reference, smokers and people with certain medical conditions are more likely to have problems with rejection – these things don’t contribute to a successful healing and they make it harder for the body to recover after injury or surgery. Even in the unlikely event of a failed graft, the situation can still be rectified either by repeating the procedure in the same way or using a piece of bone from a different part of the body, once the previous surgical site had healed sufficiently. Again, there is a possibility of failure, but there is only a tiny chance that this could happen a second time – unless the patient has serious health problems that would compound recovery.
If you are interested in getting dental implants and you think you might need a bone graft beforehand, call the Pearl Dental Clinic and arrange a consultation today; the sooner you book an appointment, the sooner your treatment can begin.