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FAQ - Bone Replacement

What is a bone graft?

Bone grafting is an oral surgical technique in which the patients bone material is enhanced or enriched. Certain disease cause a loss of bone material, which can be a problem if the patient is looking to get a dental implant, or wishes to stabilize the region where bone loss occurred.

What are bone grafts made out of?

Bone grafting material is typically broken down into four categories, namely autografts, allografts, xenografts and alloplastic or synthetic grafts. There is no competition between them, they are all equally good for the replacement and stabilization of human bone material. 

Autografts

Autografts are bone grafts where the bone material is derived from the patient receiving the bone graft. This means that a piece of bone material will be removed from one part of the patients skeleton and inserted into another, in the case of dentistry, the jawbone. Usually pieces from the iliac crest or the hip are used to replace bone material, but the preferred location is the chin, as the bone is closest to the jaw bone from that part of the body. 

Allografts

Allografts are bone grafts where the bone material is gained from another human being, usually one that is no longer alive. Many cadavers are used for organ and bone harvests, and allografts are derived from this source as well. Often enough, living hospital inpatients will also donate their bones, especially if they are undergoing hip replacement surgery.

Xenografts

Xenografts are bone grafts where the bone material is harvested from animals other than humans. Pigs are most often used for this purpose, but as many people have religious animosity towards swine, sometimes cows will be used.

Alloplastic grafts

By far the most common form of bone replacement therapy is the use of alloplastics. This is when a synthetic bone replacement agent is used to enhance the jawbone. These bone grafts are hypoallergenic, with no known cases of rejection. The material used is usually a mineral enriched hydroxylapatite, with mineral concentrations mimicking human bone materials.  

Are there any risks involved?

As with any surgery, there are some risks involved. Infections can occur if the surgery takes place in unsanitary conditions. Even in sanitary conditions and with a good dentist, there is about a 1% chance of infection. Depending on your health, there might be other risks involved as well, so be sure to mention if you are taking any medication or have any medical conditions before undergoing any oral surgery. Autografts have a higher rate of complications, as the surgery involved is more invasive, because the bone needs to be removed and than reinserted.

What sort of problems can bone grafts cure?

Bone grafts are most often used to enhance a patient’s jawbone for the reception of a dental implant. That is the primary use of bone grafts, but there are different uses as well. Any sort of dental problems that can come from depleted or diminished bone material can be sorted out with a bone graft, so tooth loss that is related to bone loss, loose teeth, and sometimes cleft palate can also be cured or managed with this procedure.    

How long is the healing time after a bone graft?

It is very hard to determine. The healing time can be anywhere between 2 and 9 months. This depends on your age, which part of the jawbone is being enhanced, your general oral condition, how much material was used, the condition of your jawbone and gums, whether or not you are a slow or faster healer, previous medical history, existing medical conditions and a host of other things. Your dentist will be able to let you know upon enquiry how long your healing time will be.

How long do I have to wait after getting a bone graft before I can get a dental implant?

Often times the dental implant is inserted at the same time the bone graft material is inserted. This means that after your healing time for your bone graft is up, you will just need to go back for an uncovering and a crown. This is most often the case, but sometimes, the bone graft needs to heal over, and than needs to be uncovered and then a dental implant can be inserted, this usually takes about six months.

What sort of bone graft can I expect to get?

At our clinic we use alloplastics, or synthetic grafting material, 99% of the time. If for some medical reason we cannot perform the surgery using alloplastics then an allograft, or a graft from your own bone material, is what will be used. We have not yet had any compelling reason to perform xenografts or autografts, although in extreme conditions the option is there.

What sort of alloplastics do you use?

We use MIS synthetic bone graft material from Apatech, or BioOSS synthetic regenerative bone replacement material. Both of these are a granule-like materials that help bones regenerate, can form a hard, bone like substance in a matter of months, and can be totally absorbed and integrated into the body. The granules are made of a surgical silicone material called silicated calcium phosphate, of which the phosphates adhere to the bone material.

Are all bone grafts successful? How long before we know if the graft was successful?

Not all bone grafts are successful. Sometimes not enough bone is generated, typically we need about 6-7 mm of jaw bone before we can safely implant. This of course depends on the implant size and which tooth is being replaced. We do not have to wait the entire healing time before we can spot the fact that the material is insufficient. Usually it can be spotted around 12-14 weeks into the process. However, the overwhelming majority of bone grafts work immediately on the first go.

Is there any way to help the healing process go faster?

Yes there is. If you place a warm material on the outside of where the bone graft has been, this will ensure that you heal quicker. Also, refrain from smoking and drinking alcohol, as these impede the healing process.

Are there any religious edicts about bone grafts?

Yes there are. Anything that involves your bodily integrity and autonomy is sure to be heavily scrutinized and scrutinized by religion. You cannot get xenografts if you are jewish, muslim, or from certain sects of hinduism. Xenografts are also out of the question if you are a jainist or if you are living under krishna consciousness. Synthetic bone grafts may also be out of the question in you are an orthodox jew, or if you are a very law abiding muslim, as these religions are very explicit about their distaste towards body modification (although the laws do stipulate that you can break them if your life is in danger, which it may be).

Autografts, bone grafts taken from your own body, are not illegal to any religion, as far as I know. This way you can be sure that you are not violating any of your religion's edicts.

 

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