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Bone Grafting


Is Bone Grafting Necessary?

With the tooth in place, the surrounding bone is stimulated with each bite. Extracting the tooth leaves a large area with no bone (extraction socket) and immediately begins the process of resorption.  There is continued loss of bone.  Bone loss continues with time. The rate of loss depends on various factors and is not the same in all individuals.  Some people lose bone much faster than others. Eventually, the bone resorbs to a level where replacement of the missing teeth with dental implants is not possible.


Types of Bone Grafting

Guided Tissue/Bone Regeneration

If a tooth socket is not grafted at the time of extraction, significant atrophy or bone loss may occur. If you desire an implant but there is not enough bone to accommodate it, a guided bone regeneration may be advised. Bone is grafted to the deficient area and covered with a membrane. This membrane will protect the graft while it is healing. Often, biologic bone growth accelerators are used in conjunction to help stimulate the graft and speed up bone growth. This can be done using allograft material, or donor bone, so a second surgical site to harvest bone is not needed. This takes 3-4 months or more to heal before and implant can be placed.

Sinus Lift

A sinus lift is used in the upper back jaw when there is not enough vertical bone for an implant. The graft is placed below the sinus membrane, essentially giving the sinus a “lift”. This is a common procedure performed either before the implant is placed or at the time of placement.

Socket Preservation

A socket preservation graft will prevent resorption of bone after an extraction.   It is designed to preserve the same vertical and horizontal dimension of bone as when the tooth was present. This is performed on the same day as extraction. After the tooth is removed, the fresh socket is filled with bone mineral that acts as a scaffold or “place holder”. Your own native bone will replace the grafted bone in a few months, leaving a ridge more suitable for an implant. This takes 2-3 months to heal before an implant can be placed.

Veneer Grafting

Veneer grafts are used when large amounts of bone are needed to graft a deficient area. These are taken from the patient’s own bone. They are usually harvested from the chin or from the back of the jaw by the wisdom teeth. The veneer graft is secured to the graft site with two mini titanium screws. Allogeneic graft or biologic growth accelerators may be used as well. The screws are removed when the implant is placed. This takes 5-6 months to heal before an implant can be placed.


Types of Bone Graft Material

Autogenous

The patient’s own bone is used as a graft to augment the desired area. This bone is usually taken from jaw. It can be harvested from the chin, or from the area near the wisdom teeth. The advantage to autogenous bone is that it contains the patients own bone cells and proteins. It can provide a scaffold for new bone to grow as well as signal the body to grow bone on its own.

Allogeneic

Allogeneic bone is human bone that is processed and sanitized for use in bone grafting. It is provided by a FDA approved bone bank. This bone works extremely well as a scaffold for your body to use to grow bone. Most of this will be resorbed and replaced by the body’s own native bone.   The majority of bone grafts performed in the office use allogeneic bone.

Xenogeneic

Xenogeneic bone is from a non-human source. Typically either bovine or porcine bone are used. These have been processed and sanitized in an FDA approved process at a national bone bank. Xenogeneic bone is sometimes added to other types of grafting when either a large volume is necessary or a longer lasting scaffold is necessary.

Biologic Bone Growth Accelerators

BMP (Bone Morphogenic Protein)

BMP is the protein that signals your body to create bone. When concentrated, it can be used alone or in addition to any type of bone substitute to regrow bone in even the most severe cases of bone loss. BMP is used mostly in sinus lifts and alveolar cleft grafting, but can be used off label in the upper and lower jaws to regenerate bone predictably.

PRF (Platelet Rich Fibrin)

PRF is derived from the patient’s own blood and contains fibrin and stem cells that can be mixed with the bone graft or added on top of a bone graft. PRF increases the quantity of available growth factors to enhance the body’s regeneration of new bone. This procedure is easily performed in the office at the same surgical appointment.

Emdogain

Emdogain is a protein-based gel that is derived from the cells in developing teeth. It is designed to promote predictable regeneration of lost hard and soft tissues around teeth. Dr. Loveless has been using it off-label to predictably salvage implants that have mild to moderate bone loss. Implants that others may deem unsalvageable can often be successfully grafted and stabilized for continued use.

Post-Operative Instructions after Bone Grafting

Oral surgical care in a safe, warm, and caring environment!

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5 of 5 stars of 811

What can I say? No one likes to visit the dentist…especially for anything other than having their teeth cleaned. I am no different. Hated that I had to have a tooth taken out but it was necessary. I was referred here by my dentist to see Dr. Loveless. If I ever have to have anything else done from an oral surgeon, I would never wish to see anyone else. Dr. Loveless and his staff not only made me feel less anxious but they were super nice and made sure that I knew everything that was being done. I would refer them to anyone with complete confidence! If I could give them more than 5 stars, I would. I want to tell them all thank you for making this process much easier on me. Just an amazing staff and surgeon!!

5 of 5 stars of 811

Dr. Loveless did an amazing job. I needed a wisdom tooth extracted that had a large cavity. He got it out whole in less than 1 minute. He is great. His staff is wonderful too. My whole experience was great. I will refer anyone that needs an oral surgeon!

Pamela W.
Happy Patient

5 of 5 stars of 811

Excellent oral surgeon. I had to have my wisdom teeth removed and was terrified. The staff at Archway were very professional and took care of me. Painless proceedure and I was in and out in a hour. highly recommended thank you very much!

Patrick H.
Happy Patient

5 of 5 stars of 811

“…we were happy to find somoeone that was caring…we will never forget the care and concern you showed to our mother”

5 of 5 stars of 811

I had a great experience at Archway. I went there to get four wisdom teeth removed. The office was clean. The staff was nice and efficient. Dr. Loveless was warm and the Spotify music was a nice touch. The procedure went through with no problems and I didn’t feel a thing. I received a post op call and great instructions. Overall, the experience exceeded my expectations after you hear all the horror stories regarding wisdom teeth removal.

5 of 5 stars of 811

This surgeon is great. ALL his staff is outstanding. Had implant done, basically painless, very interesting procedure. Assistant /hygienist (practically doctor) Emily was great. Highly recommend this office.

Larry C.
Happy Patient

5 of 5 stars of 811

“You are an awesome doctor! Also, your assistants were great and made everything so much easier. Thank you for being such a caring doctor.”

5 of 5 stars of 811

My experience with the ladies and Doctor Loveless was great. I had never been put under by anesthesia before and they made me comfortable and very relaxed. They took care of me from the beginning consultation to leaving minus 4 teeth. Thankfully Dr. Loveless is a younger man so he will hopefully be around to treat my children with the same care, someday.

5 of 5 stars of 811

Dr. Loveless,

Thank you for making my tooth extraction so quick and easy. I was expecting a lot of pain. Haven’t experienced any residual pain, either since I woke up the following morning. You should hang a shingle stating “painless Dentist”!! Also, your staff is so kind and attentive. I would definitely come back when needed, and recommend you to anyone in need. Though I don’t wish that pre-surgery pain on any person (or animal) for that matter!

 

5 of 5 stars of 811

I went to have my wisdom teeth removed and it was the most pleasant experience. The staff and physician were very friendly and immediately put me at ease. The office was beautiful and exceptionally clean and I would definitely recommend their services to anyone and everyone!

Holly P.
Happy Patient

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