Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries.

Bome Grafting
Bone Graft glendale

What is bone grafting?

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries.

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.

Types of Bone Grafts

Autogenous bone grafts, also known as autografts, are made from your own bone, taken from somewhere else in the body. The bone is typically harvested from the chin, jaw, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is live bone, meaning it contains living cellular elements that enhance bone growth.

Allogenic bone, or allograft, is dead bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on it’s own. Rather, it serves as a framework or scaffold over which bone from the surrounding bony walls can grow to fill the defect or void.

Xenogenic bone is derived from non-living bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenogenic grafts serve as a framework for bone from the surrounding area to grow and fill the void. Both allogenic and xenogenic bone grafting are advantageous in that they do not require a second procedure to harvest your own bone, as with autografts. However, because these options lack autograft’s bone-forming properties, bone regeneration may take longer than with autografts, with a less predictable outcome.

Bone Graft Substitutes

  • Problems with remaining teeth, including, misalignment, drifting, loosening and loss
  • Collapsed facial profile
  • Limited lip support
  • Skin wrinkling around the mouth
  • Distortion of other facial features
  • Jaw (temporomandibular joint [TMJ]) pain, facial pain, and headaches
  • Difficulty speaking and communicating
  • Inadequate nutrition as a result of the inability to chew properly and painlessly
  • Sinus expansion

Graft composites consist of other bone graft materials and growth factors to achieve the benefits of a variety of substances. Some combinations may include: collagen/ceramic composite, which closely resembles the composition of natural bone, DBM combined with bone marrow cells, which aid in the growth of new bone, or a collagen/ceramic/autograft composite.

Bone morphogenetic proteins (BMPs) are proteins naturally produced in the body that promote and regulate bone formation and healing.

Synthetic materials also have the advantage of not requiring a second procedure to harvest bone, reducing risk and pain. Each bone grafting option has its own risks and benefits. Dr. Malek will determine which type of bone graft material is right for you.

Bone Grafting

How Dr. Malek Can Help

Major & Minor Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different sites depending on the size of the defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.

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Malek periodontics

The Importance of Teeth for Jawbone Health

Bone Grafting

Your teeth affect your whole body. When they’re healthy, you’re healthier too.

When one or more teeth are missing, it can lead to jawbone loss at the site of the gap. This loss of jawbone can develop into additional problems, both with your appearance and your overall health.

You may experience pain, problems with your remaining teeth, an altered facial appearance, and eventually even the inability to speak and eat normally. In that same way that muscles are maintained through exercise, bone tissue is maintained by use. Natural teeth are embedded in the jawbone, and stimulate the jawbone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jawbone that anchors the teeth in the mouth, no longer receives the necessary stimulation, and begins to break down, or resorb. The body no longer uses or “needs” the jawbone, so it deteriorates and goes away.

Reasons for Jawbone Loss and Deterioration

The following are the most common causes for jawbone deterioration and loss that may require a bone grafting procedure:

  • Problems with remaining teeth, including, misalignment, drifting, loosening and loss
  • Collapsed facial profile
    Limited lip support
  • Skin wrinkling around the mouth
  • Distortion of other facial features
  • Jaw (temporomandibular joint [TMJ]) pain, facial pain, and headaches
  • Difficulty speaking and communicating
  • Inadequate nutrition as a result of the inability to chew properly and painlessly
  • Sinus expansion

When an adult tooth is removed and not replaced, jawbone deterioration may occur. Natural teeth are embedded in the jawbone, and stimulate the jawbone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jawbone that anchors the teeth in the mouth, no longer receives the necessary stimulation, and begins to break down, or resorb. The body no longer uses or “needs” the jawbone, so it deteriorates and goes away. The rate the bone deteriorates, as well as the amount of bone loss that occurs, varies greatly among individuals. However, most lost occurs within the first eighteen months following the extraction, and continues throughout life.

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum, or gingiva. While there are many diseases which affect the tooth-supporting structures, plaque-induced inflammatory lesions make up the majority of periodontal issues, and are divided into two categories: gingivitis and periodontitis. While gingivitis, the less serious of the diseases, may never progress into periodontitis, it always precedes periodontitis.

Dental plaque is the primary cause of gingivitis in genetically-susceptible individuals. Plaque is a sticky colorless film, composed primarily of food particles and various types of bacteria, which adhere to your teeth at and below the gum line. Plaque constantly forms on your teeth, even minutes after cleaning. Bacteria found in plaque produce toxins or poisons that irritate the gums. Gums may become inflamed, red, swollen, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. If daily brushing and flossing is neglected, plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.

Periodontitis is affected by bacteria that adhere to the tooth’s surface, along with an overly aggressive immune response to these bacteria. If gingivitis progresses into periodontitis, the supporting gum tissue and bone that holds teeth in place deteriorates. The progressive loss of this bone, the alveolar, can lead to loosening and subsequent loss of teeth.

Malek periodontics office
Malek periodontics

Types of Bone Graft Procedures

Ridge Augmentation | Sinus Augmentation | Socket Preservation

Ridge Augmentation

A ridge augmentation is a common dental procedure often performed following a tooth extraction to help recreate the natural contour of the gums and jaw that may have been lost due to bone loss as a result of a tooth extraction, or for another reason.

A ridge augmentation is a common dental procedure often performed following a tooth extraction to help recreate the natural contour of the gums and jaw that may have been lost due to bone loss as a result of a tooth extraction, or for another reason.

The alveolar ridge of the jaw is the bone that surrounds the roots of teeth. When a tooth is removed, an empty socket is left in the alveolar ridge bone. Sometimes this empty socket will heal on its own, filling with bone and tissue, however often times it does not. Sometimes when a tooth is removed, the bone surrounding the socket breaks, and it unable to heal on its own. The previous height and width of the socket will continue to deteriorate.

Rebuilding the original height and width of the alveolar ridge may be required for dental implant placement, or for aesthetic purposes. Dental implants require bone to support their structure, and a ridge augmentation can help rebuild this bone to accommodate the implant.

A ridge augmentation is accomplished by placing bone graft material in the tooth socket. It is often done immediately after the tooth is removed, to avoid the need for a second procedure later. Next, the gum tissue is placed over the socket and secured with sutures. Once the socket has healed, the alveolar ridge can be prepared for dental implant placement.

A ridge augmentation procedure is typically performed in Dr. Malek’s office under local anesthesia.

Sinus Augmentation

The key to a successful and long-lasting dental implant is the quality and quantity of jawbone to which the implant will be attached. If bone loss has occurred due to injury or periodontal disease, a sinus augmentation can raise the sinus floor and allow for new bone formation.

The maxillary sinuses are behind your cheeks and on top of the upper teeth. These sinuses are empty, air-filled spaces. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

The key to a successful and long-lasting dental implant is the quality and quantity of jawbone to which the implant will be attached. If bone loss has occurred due to injury or periodontal disease, a sinus augmentation can raise the sinus floor and allow for new bone formation.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option besides wearing loose dentures.

Socket Preservation

Jaw deformities from tooth removal can be prevented and repaired by a procedure called socket preservation.

Removal of teeth is sometimes necessary because of pain, infection, bone loss or fracture of the tooth. The bone that holds the tooth in place (the socket) is often damaged by disease and/or infection resulting in deformity of the jaw after the tooth is extracted. In addition, when teeth are extracted, the surrounding bone and gums can shrink and recede very quickly after the extraction resulting in unsightly defects and collapse of the lips, and cheeks. These jaw defects can create major problems in performing restorative dentistry whether your treatment involves dental implants, bridges or dentures. Jaw deformities from tooth removal can be prevented and repaired by a procedure called socket preservation. Socket preservation can greatly improve your smile’s appearance and increase your chances for successful dental implants for years to come.

Several techniques can be used to preserve the bone and minimize bone loss after an extraction. In one common method, the tooth is removed and the socket is filled with bone. It is then covered with gum, artificial membrane, or tissue stimulating proteins to encourage your body’s natural ability to repair the socket. With this method, the socket heals eliminating shrinkage and collapse of surrounding gum and facial tissues. The newly formed bone in the socket also provides a foundation for an implant to replace the tooth. If your dentist has recommended tooth removal, be sure to ask if socket preservation is necessary. This is particularly important if you are planning on replacing the teeth with a dental implant.

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Malek Periodontics

20100 N 51st Ave #F650
Glendale, AZ 85308

T: 623.362.8969
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About Dr. Malek

Tannaz Malekzadeh, DMD

Serving Maricopa County and the West Valley area

Dr. Tannaz Malekzadeh your Glendale AZ Periodontist, provides Periodontal Services including Non-Surgical procedures, Bone Grafting, Dental Implants, Cosmetic Periodontal Surgery, Gum Grafting, Osseous Surgery, and Treatment for Gum Disease.

For more information about our practice or to schedule a consultation with Dr. Malek, call our office in Glendale, AZ.
623.362.8969

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