Bone Graft for a Dental Implant

[oceanmd]

My dentist referred me to a periodontist / implant specialist to have a 3-D X-ray of the root of the tooth.
While making the appointment, I asked about the implant placing stages and was surprised to hear that after the tooth extraction, the bone graft needs to be performed.

My questions regarding the bone graft:

Does everybody need a bone graft? Can your own body generate the bone during healing?

What material was used in your implant placing?

Did anybody here have their own bone harvested from your body for a bone graft?

 

[W2R]

My dentist referred me to a periodontist / implant specialist to have a 3-D X-ray of the root of the tooth.
While making the appointment, I asked about the implant placing stages and was surprised to hear that after the tooth extraction, the bone graft needs to be performed.

My questions regarding the bone graft:

Does everybody need a bone graft? Can your own body generate the bone during healing?

What material was used in your implant placing?

Did anybody here have their own bone harvested from your body for a bone graft?

I had bone grafts done on about half my implants (the ones in my upper jaw? I think) but not from my own bone. It wasn't a big deal for me and this was about 5-10 years ago. Here's a post that I wrote about the procedure back when it was done:

https://www.early-retirement.org/fo...apart-piece-by-piece-85638-3.html#post1851320

IIRC, in my case the bone cells were originally from a cadaver. They were suspended in liquid of some kind, in a vial, and the oral surgeon just painted them onto my tooth with a brush. Took about 5 minutes. Then, there is a waiting time (maybe a couple of weeks?) while they grow and meld with the tooth tissue I guess. Maybe somebody who has had this done more recently can give you better information. But anyway, it's nothing to worry about IMO.

 

[Luvtoride]

I was told I would not only need a bone graft but a sinus lift (not sure why exactly). My regular dentist, whose brother is a periodontist told me NOT to do it. She is making me a Valplast Partial for where these 2 upper back molars would go.

 

[becca]

I started down that road a couple years ago. First the tooth was pulled and bone graft done. They put the bone graft material (not mine) in when the tooth was pulled, not a big deal. Then you wait a couple months and come back and they xray you to see if the bone has grown. At that point they told me I needed a sinus lift. The cost of the process before the sinus left was $5k. The sinus lift was going to be additional $.

The missing tooth is in the back and does not show when I smile. I'm 71 yo. I decided to just live with the missing tooth and so far I have had no problem.

 

[VanWinkle]

I went through this last year with 2 implants. The teeth were pulled and in about a month, the bone graft and implants were done at the same time. 3 months later, one implant did well and the other bone graft was not successful. The second implant had to be removed and the bone graft done a second time. There was no implant done the second time so the bone graft could have some time to respond. Now I am ready for the second implant as the bone graft was successful the second time.
New Dentist for me in a new state so maybe this is normal, or maybe he's not that good. I wonder if the implant and bone graft should have been done at the same time.

VW

 

[athena53]

I've had 8 implants now. (Yeah, do the math- except my oral surgeon has one patient with 16.) Every one has included a bone graft and every one has been successful, thank God. My dentist always looks at my annual X-rays and remarks how well the implants have "osseo-integrated". At one point the oral surgeon said there was even something they could add during the bone graft that would give it a better chance of working but that THEIR cost was $1,000/vial.

Sinus lifts are another matter- I'm grateful I've never needed one. Oral surgeon says my sinuses are "sky-high". They need enough thickness of bone to drill into that hey don't poke into a sinus cavity, which apparently is a very Bad Thing.

My one complaint: the blood bank defers me for a few months after a cadaver graft even though I'm sure my oral surgeon uses only the finest cadavers.

 

[oceanmd]

My one complaint: the blood bank defers me for a few months after a cadaver graft even though I'm sure my oral surgeon uses only the finest cadavers.

Athena, can you elaborate on this deferral?

 

[Car-Guy]

I had a molar extracted about 8 months ago and the dentist did a graft to fill the void and "in case" I might want to have an implant later. I really don't know what material he used for the graft but it only took a few minutes (if that) to complete. The material looked like this.

No problem then or since.

 

[athena53]

Athena, can you elaborate on this deferral?

I just did a Google search- looks like 3 months deferral is typical. I suppose the reasoning is that you might get some sort of disease the donor had but I can't imagine how that's even possible. The blood banks typically are over-cautious, which makes sense given that recipients are a vulnerable population.

You'd also asked if your own body could generate bone during healing. Yes, it can. I remember that after one of my implants they had to chip away at it since the new bone partially covered the implants!

 

[oceanmd]

You'd also asked if your own body could generate bone during healing. Yes, it can. I remember that after one of my implants they had to chip away at it since the new bone partially covered the implants!

I had the same experience with my bottom implant, the only implant at this time. The titanium post was placed, I was made aware before the procedure that the bone graft might be necessary. While drilling and taking control X-rays, the surgeon told me that it was not necessary.

After 8 months when I came to have the healing cap placed, he had to drill some to get to the implant saying that I generated a lot of bone over it.

This is why I am asking if there are people who had their implants placed without doing bone graft.

 

[Teacher Terry]

As is typical I had enough bone on the bottom to not need a bone graft. If I get any on the top I would need one. 40 years ago my sister had full mouth implants and they had to take bone from her hip which involved surgery. I think now having cadaver bone is much better.

 

[oceanmd]

As is typical I had enough bone on the bottom to not need a bone graft. If I get any on the top I would need one. 40 years ago my sister had full mouth implants and they had to take bone from her hip which involved surgery. I think now having cadaver bone is much better.

How did your sister's hip heal after the surgery?

 

[Teacher Terry]

It healed fine but she was only 38 years old. If cadaver bone had been available she would not have had it done. It’s also expensive.

 

[oceanmd]

It healed fine but she was only 38 years old. If cadaver bone had been available she would not have had it done. It’s also expensive.

I also read that now they can grind the bone from the place where the wisdom tooth used to be.

I have no idea of the cost of this procedure.

Also, the dentist who placed my bottom implant looked at the upper location for the implant and said that it might not need a bone graft either. He will know when he is working on it.

He has already retired. Therefore, I am exploring this issue to be prepared.

 

[pacergal]

My bone graft("sand" the doc called it) looked similar to the pic from Car-Guy Post #8, placed after I had a apioectomy, trying to save the tooth prior to needing implant. Ended up needing the implant anyway.

 

[easysurfer]

For my dental implant, glad that I didn't know about the cadavers start until afterwards. Now that's what I call recycling .

 

[zl55lz]

I was told I would not only need a bone graft but a sinus lift (not sure why exactly). My regular dentist, whose brother is a periodontist told me NOT to do it. She is making me a Valplast Partial for where these 2 upper back molars would go.

Did your dentist elaborate as to why not to do it (at least in your case)? Was she referring to the bone graft or the sinus lift or both?

 

[oceanmd]

Saving the tooth from extraction

Did anybody have a fractured root saved using this method or any other method?

Vertical root fracture is a big challenge to dentists for its diagnosis and treatment. As the tooth presents poor prognosis, the most common treatment modality is extraction. One can save the tooth from extraction with the help of Biodentine, a bonding agent, a fiber post, and dual-cure resin cement without tooth extraction, followed by all ceramic crowns. Up to two years of follow-up, there is no problem in the tooth, and radiographically, there is no radiolucency along the fracture line. Periodontal status and probing depth were within a normal physiological limit.

 

[Walt34]

... even though I'm sure my oral surgeon uses only the finest cadavers.

Well, one wouldn't want just any cadaver parts that Igor dug up from just anywhere....

 

[gailwinters]

I had a molar extracted about 8 months ago and the dentist did a graft to fill the void and "in case" I might want to have an implant later. I really don't know what material he used for the graft but it only took a few minutes (if that) to complete. The material looked like this.

No problem then or since.

This is what my graft material looked like, too. It was placed immediately after my extraction. I had no problems at all with the graft or my implant.

 

[MC Rider]

Well, one wouldn't want just any cadaver parts that Igor dug up from just anywhere....

You need the ones from Abbie Normal.


I was told I had too much bone loss to be a good candidate for implants.
The perio guy did say they could try drilling into my sinus. Um, no grazi.

 

[SecondAttempt]

I had a tooth that stealth decayed went right to the root with no pain or other evidence of decay until too late. I opted for an implant since it was a visible tooth.

Implant surgeon (MD) did lots of fancy imaging and said my bone looks solid. He did the extraction. Then you wait a few months. When he sent to drill for the implant all was good but then when he tried to install the screw base he could not get it to hold so I was suddenly on the bone graft plan. He told me what was happening, spent 5 minutes packing the socket with someone else's bone, and told me to come back in 3 months. When I came back he successfully installed the implant and all has been good since. I had to go back to my regular dentist to get it crowned though. That was about 5 years ago and no issues since.

 

[oceanmd]

I had a tooth that stealth decayed went right to the root with no pain or other evidence of decay until too late. I opted for an implant since it was a visible tooth.

Implant surgeon (MD) did lots of fancy imaging and said my bone looks solid. He did the extraction. Then you wait a few months. When he sent to drill for the implant all was good but then when he tried to install the screw base he could not get it to hold so I was suddenly on the bone graft plan. He told me what was happening, spent 5 minutes packing the socket with someone else's bone, and told me to come back in 3 months. When I came back he successfully installed the implant and all has been good since. I had to go back to my regular dentist to get it crowned though. That was about 5 years ago and no issues since.

Was it your upper or lower tooth?

 

[SecondAttempt]

Was it your upper or lower tooth?

Upper, I would tell you which one but I'm not sure how the numbering goes. It is what I think is commonly called the canine.

 

[5Miler]

I went through my first implant last year, actually started with the extraction in late 2022 and the implant/bone graft surgery in May 2023. Delayed due to my long schedule dive vacation. It was possible I would need a sinus lift as it was an upper (#14) and diving right after a sinus lift is a recipe for disaster.

The bone graft is a non event as far as I'm concerned as it was done in conjunction with the implant placement. The only issue I had was occasionally spitting out bone fragments for the first few days. Kind of freaked me out for a bit as I wasn't sure what it was.

Ended up not needing the sinus lift so all was well.

Now that I think about it, the graft was done during the extraction, not the implant placement.