Bone
Grafting & Guided Bone Regeneration
Today, more
than ever, advances in medicine and dentistry have led to new and
expanded areas of treatment. Two such areas, bone grafting and guided
bone regeneration (GBR) in the jaw bones and around teeth, have
recently experienced tremendous growth. Procedures to repair and
grow new bone, unheard of just a few years ago, are now part of
routine dental surgical care. This page will help you better understand
what bone grafting and GBR are, what options are available to you
and what benefits you may gain from these procedures.
What
are bone grafting & GBR?
Bone grafting
is a surgical procedure that replaces missing bone with a material
called a bone graft. This material not only replaces missing bone,
but also helps your body regrow lost bone. This new bone growth
strengthens the grafted area by forming a bridge between your existing
bone and the graft. Over time the newly formed bone with replace
much of the grafted material. GBR is a procedure in which a membrane
is placed over the bone graft site. This membrane further encourages
new bone to grow and also prevents the growth of scar tissue into
the grafted site.
Why
are bone grafts & GBR needed?
Bone grafts
& GBR are needed when a part of your body is missing bone. This
missing portion of bone is frequently called a "bony defect".
Examples of jaw bone defects are: defects surrounding roots of teeth
(periodontal defects); defects which occur following tooth extraction;
generalized decrease in quantity of jaw bone from trauma or long-term
tooth loss; defects surrounding dental implants; defects resulting
from cyst or tumor surgery.
How
are bone grafting & GBR procedures performed?
The following
is one example of these procedures following tooth extraction.
1. The tooth
is removed and the remaining tooth socket is thoroughly cleaned
of all inflamed and infected tissue.
2. An appropriate
bone grafting material is carefully placed into the extraction socket.
3. GBR membrane
is often placed over the grafted material.
4. Sutures placed
into the gum tissue allow proper healing of the surrounding soft
tissues.
Are
bone grafting & GBR painful procedures?
These procedures
are usually done in the doctor's office under local anesthesia or
local anesthesia with I.V. sedation or occassionally general anesthesia.
The procedures themselves are without pain. Post-operatively, there
will be some swelling and some mild to moderate discomfort, especially
from other procedures performed, such as tooth extraction, cyst
removal, etc. Your doctor will prescribe an oral analgesic to help
relieve your discomfort. If a more invasive second procedure is
required to obtain bone (i.e. from your hip, chin area, etc.) then
your post-operative discomfort will be increased but still manageable.
What
special care is required after my grafting procedure?
Generally, the
same prudent care required after any dental surgical procedure will
be sufficient following jaw bone grafting & GBR. The area must
be kept clean, often with the help of a prescribed mouth rinse.
An antibiotic, if prescribed by your doctor, must be taken. Antibiotics,
however, are not always required. Undue pressure over the grafted
site must be avoided until new bone is well on its way to being
formed. This means that previous dental prostheses, such as a removable
full or partial denture, must be altered by your dentist following
the grafting procedure. And finally, brush and floss your teeth
as you normally do. However, avoid the gum tissues surrounding the
bone graft until they are well healed (usually about six weeks).
How
successful are bone grafting & GBR?
Recent advances
in technology have dramatically increased the success of these procedures,
leading to bone formation and resolution of the defect. However,
depending upon the reason needed for these procedures, success rates
will vary. Also, different graft & GBR materials seem to affect
the amount of new bone formed. And finally, your own overall health
will also help determine the degree to which new bone will form
within the grafted site.
Are
there different types of bone grafts & GBR membranes?
Yes. Some grafts
are taken from different parts of the patient's own body (i.e. from
the hip bone or chin). Other grafts come from deceased human organ
donors, from synthetic materials, and from highly purified bone
mineral. Likewise, there are different types of GBR membranes. Some
are made from synthetic polymers and must be removed during a second
surgery several weeks or months later. Others are made from natural
materials and are gradually resorbed (melt away) by the body.
What
type of grafts are used at your office?
We use Bio-Oss
which is a safe, effective bone grafting material from specialty
processed bovine sources. Under the electron microscope, Bio-Oss
looks very similar to human bone. Because of its similarity to human
bone, Bio-Oss is highly successful in helping new bone to form.
In many cases, using Bio-Oss eliminates the need for additional
surgery to obtain your own bone as grafting material.
How
does Bio-Oss work?
Since Bio-Oss
is so similar to human bone, it is readily accepted by our defense
mechanisms as a "friendly" graft and is therefore not
rejected. Bio-Oss acts as a framework onto which bone forming cells,
blood vessels, etc. migrate. As these cells and blood vessels travel
along the Bio-Oss framework, healthy new bone is formed and the
defect is repaired.
Is
Bio-Oss safe?
Bio-Oss is completely
safe. Since it is highly purified bone, no allergic reactions or
infections have been observed following its use. Every batch of
Bio-Oss goes through highly controlled processing and sterilization
procedures which remove all impurities. At the end of these procedures,
every batch of Bio-Oss must pass rigorous tests for purity and sterility,
assuring the total safety of materials.
How
long does it take for new bone to form around the Bio-Oss graft?
Bio-Oss, because
of its similarity to human bone, is highly successful in supporting
new bone growth. Although new bone will begin to form within the
first few weeks after grafting, several months are required to achieve
the quantity and density of bone needed for further dental or surgical
procedures to be performed. (Time may vary. Ask your dentist about
your specific case.)
What
type of GBR membranes are used at your office?
We use Bio-Gide
which is a thin resorbable GBR membrane made from the natural fiber
material, collagen. Often when a bone graft is needed, Bio-Gide
is placed directly over the grafted material. Bio-Gide encourages
new bone to form and also prevents the growth of scar tissue into
the grafted site.
How
is Bio-Gide different from other membranes?
Bio-Gide is
resorbable (melts away) and therefore, unlike membranes which do
not resorb, does not need a second surgical procedure to be removed.
Unlike most other resorbable membranes which tend to resorb in 4-8
weeks. Bio-Gide lasts at least 4 months, the time required for new
bone to form. And lastly, during healing, if an opening occurs in
the gum tissue covering Bio-Gide, the opening will tend to clse
spontaneously, allowing bone growth to continue. Removal of the
Bio-Gide membrane is almost never required.
Is
Bio-Gide safe?
Bio-Gide, like
many artificial membranes, is composed of porcine delivered collagen.
Using special processing and sterilization procedures, Bio-Gide
is made completely biocompatible and sterile. Every batch of Bio-Gide
membranes undergoes a series of tests confirming its purity and
sterility, assuring total safety of the materials. Bio-Gide is not
indicated for patients with a known history or allergic response
to collagen or porcine derived products.
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Co.
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