San Francisco Surgical Arts

What is a bone graft? Do I need one?

Bone Grafting Procedures are Commonly Needed Before Placing Implants:

In order to place an implant the jawbone must have a certain amount of thickness (width), length and density.   Sometimes when a tooth and its surrounding structures have suffered from things such as infection or bone resorption the site can be deemed unsuitable for the placement of  an implant unless bone grafting is done to create additional bone to stabilize the implant.

During a bone grafting procedure, the added bone will be placed into the socket of the missing tooth or extraction site .  The bone graft itself can come from many sources.

One of the most common sources used today to create additional bone for denta implant stability is bovine (cow) bone  which is classified as a xenograft.   Often times, the bone grafted material (depending on its source)  will act as a scaffold for your native bone to form over it or potentially can even induce your own body to form additional bone in the grafted area.

Another type of bone grafts is autogenoeous grafting, or a graft taken from the patient’s own body.  There are many places in the patient’s body that he bone may be taken from.  Most commonly the bone is taken from the mandible though additional potential donor sites include but are not limited to the chin, skull, hip or leg.  The advantage of autogeneous graft is that it is your body’s own bone with the obvious disadvantage being that it requires an additional time donor site surgery as well as surgical time thereby causing the patient potentially more discomfort and a longer healing time.  There is also a limit to the amount of bone that we can harvest from an autogenous source.

Grafts may also come from human cadavers with these types of grafts being called allografts.  Allografts come from tissue banks or bone banks that have very strict guidelines and safety protocols.   These types of grafts  have been used in medicine and dentistry for many years with a good safety track record.

These are just some of types of bone grafting materials that are being used today to help create more stability and bone around dental implants.   This technology is always evolving and we remain on the cutting edge of this technology though we are also cautious to use techniques which are the most likely to be successful for you.

Your dentist will recommend the type of grafting, if any, that is the best for you.

Once a graft is placed it takes 4 -6 months for the graft to osseointergrate with the patient’s natural bone.  Once the bone has reached a desired density and shape an implant may be placed in the bone.  Usually the implant will then take another 4-6 month to osseointergrate with the patient’s bone before the cosmetic restoration can be placed acting as a fully functioning tooth.

Osseointergrate:

Osseointergrate:  Osseointegration derives from the Greek osteon, bone, and the Latin integrare, to make whole. The term refers to the direct structural and functional connection between living bone and the surface of a load-bearing artificial implant. …

https://www.google.com/search?q=define+osseointergrate&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a#hl=en&client=firefox-a&hs=ZPT&rls=org.mozilla:en-US:official&q=osseointegration&tbs=dfn:1&tbo=u&sa=X&psj=1&ei=tsd4T5TZDYHL2QXNoPC1Bg&ved=0CCcQkQ4&bav=on.2,or.r_gc.r_pw.r_qf.,cf.osb&fp=7eb002691ce0398a&biw=1280&bih=581

At what age does my child need his/her wisdom teeth removed?

How do you know when it is time for your child to have his or her wisdom teeth removed?  All children progress at different rates, both physically and emotionally.  Most children will have their wisdom teeth extracted somewhere between the ages of 15 through 21, although some children may never need to have their wisdom teeth removed.  Typically speaking, the longer we wait to have our wisdom teeth removed, the more difficult and dangerous the procedure may be.  Reasons to have wisdom teeth extracted include pain, infection, lack of space in the oral cavity, inability to keep wisdom teeth clean, decay, and damage to the adjacent second molars.

Your general dentist can tell you if and when wisdom teeth extraction is necessary.  In order to properly diagnosis this, a dentist will perform an oral examination and take x-rays.

 

There are many reasons why the wisdom teeth may need to be removed.

Please refer to our website for more information: https://www.sfsurgicalarts.com/procedures/wisdom-teeth.asp

 

 

What happens if I do not replace a missing tooth?

There are several reasons why one should replace a missing tooth.

 

One of the most common reasons people seek replacing a missing tooth is for aesthetics.  Simply put, it just looks nice to have a healthy smile with straight white teeth.  Unfortunately not all of us are so lucky to just naturally have a nice smile.

“About 78 percent of Americans have had at least one cavity by age 17 “. ¹

Sometimes cavities are too severe to fix with a simple restoration or tooth decay has progressed to the point that the tooth is likely non-salvageable.   In these cases we may need to remove the tooth from the mouth in order to prevent further damage to the surrounding tissues, bone and remaining teeth.

 

Perhaps the next most common reason to replace a missing tooth is because of function.  Your teeth have a purpose.  They are used for smiling, eating and communicating.  If you are missing a tooth or several teeth it may affect your ability to pronounce certain words correctly.  Missing teeth may also affect your ability to chew and digest food properly.

 

Furthermore, a gap in your smile may contribute to development of a  malocclusion.  Misaligned teeth can become very problematic as the teeth surrounding the missing tooth will tend to shift towards each other in order to fill in the gap.  In some  cases this can cause the the opposing teeth to supererupt, potentially increase sensitivity to sweets and temperature, and lead to tooth mobility.

 

Another reason to replace a missing tooth is to prevent bone resorption.  The roots of the teeth promote healthy bone development.  “Bone tissue is maintained by putting stress or load on it through the periodontal ligament; activities such as biting and chewing stimulate the root structure, which in turn stimulates the bone that the root is attached to.  When a permanent (adult) tooth is removed and not replaced, bone stimulation stops at that particular site, and the alveolar bone – the portion of the jaw bone that anchors the teeth in the mouth – no longer receives this physical stimulation and starts to resorb. Bone resorption is the natural process by which large cells called osteoclasts break down bone.” ²

When the bone resorbs the face can appear misshapen or sunken-in through the cheeks and jaw-line.  Also the bone becomes less functional not properly supporting the surrounding teeth.  Please view this video for more information: http://www.youtube.com/watch?v=69OxyJ5Ok50&feature=endscreen&NR=1

 

 

 

 

 

1. Centers for Disease Control and Prevention. Oral Health 2000: Facts and Figures. Available at: http://www.cdc.gov/oralhealth/publications/factsheets/sgr2000_fs1.htm

2. https://www.infusebonegraft.com/omf_reasons_for_jaw_bone_loss.html

Osteoclast

Osteoclast: A cell that nibbles at and breaks down bone and is responsible for bone resorption.

http://www.medterms.com/script/main/art.asp?articlekey=11794

Alveolar bone

Alveolar bone: in dentistry, the specialized bony structure that supports the teeth; it consists of the cortical bone that comprises the tooth socket into which the roots of the tooth fit, and is supported by the trabecular bone. Syn: alveolar supporting bone

http://dictionary.webmd.com/terms/alveolar-bone

Resorption

Resorption: The process of losing substance. For example, when bone is surgically reshaped, it undergoes both new formation and resorption.

http://www.medterms.com/script/main/art.asp?articlekey=5327

Tooth mobility

Tooth mobility physiologic movement of a tooth, varying in degree for different teeth and different times of day; that exceeding a normal range is pathological.

http://medical-dictionary.thefreedictionary.com/tooth+mobility

Supererution

Supererution is when the tooth errupts more than it is meant to; tooth eruption is the process by which the tooth moves from its site of formation to its position of function. It can be active or passive.

http://medical-dictionary.thefreedictionary.com/tooth+eruption