Oral Surgery Procedures | Southern California Center for Oral and Facial Surgery

Bone and Tissue Grafting

In certain cases, due to injury or atrophy over time, there is an inadequate volume of tissue or bone necessary to successfully place dental implants. When this occurs, it is possible to rebuild the jaws so that dental implants can be placed. This is done by placing grafts of bone or other tissues into the area where they are needed.

Depending on the location and the amount of tissue needed, the graft may be obtained from the patient, from a bone and tissue bank, or sometimes a synthetic substitute material is used. Each of these has certain advantages and disadvantages. The best solution for a particular patient is decided after consultation with the surgeon and the alternatives are discussed.

Bone Grafting

In patients who have been missing teeth in an area for a long time, there tends to be loss of the bone by a process known as resorbtion. If this is severe enough, there may not be adequate bone for the placement of dental implants.

For small defects, freeze-dried bone from a bone bank is usually used. This may be mixed with a ceramic material that has the same mineral component as natural bone. This is allowed to heal over a 4 - 8 month period, during which the graft solidifies and is converted to bone. Implants are then placed after this healing period. Sometimes, the graft can be placed at the same time as the implants, reducing the total treatment time.

For larger defects, where a larger quantity of bone is needed, bone may be taken from another site and placed where it is needed. This technique has the advantage of transplanting living bone cells from the same patient, thus improving the success of the grafting procedure.

The disadvantage is that it requires an additional surgical site from which to harvest the bone. For many patients this disadvantage is far outweighed by the improved outcome and function of the surgery.

Soft Tissue Grafting

Sometimes, once a bone graft is placed, there is not adequate amount of tissue to close the wound without compromising healing.

In these cases, a soft tissue graft may be used to cover part of the bone graft to facilitate its healing. Tissue can be obtained from other parts of the mouth or skin, or from a tissue bank.