Bone is an essential support structure for the teeth, dental implants, and even dentures. Bone loss usually occurs as a result of periodontal disease or in the event that a tooth is extracted. Other causes may involve trauma or a disease of the bone. Generally, we do everything medically possible to preserve the bone because it does not grow back on it’s own. In the event that a tooth extraction is necessary we make every attempt to bone graft the site to maximize the formation of new bone in the tooth socket. If the extraction site is not bone grafted, blood fills into the site and the body does generate bone where the tooth root was removed. However, placing a bone graft at the time of the tooth extraction greatly increases the amount of bone formation and reduces the amount of bone loss associated with this procedure. Bone grafting provides a scaffolding for the formation of new bone – it gives your body a head start by providing the non-cellular component of bone. Bone grafting is especially important if you are planning to restore an extracted tooth with a dental implant of if it is an upper tooth with surrounded by an enlarged maxillary sinus. If a dental implant is not placed in the site where the tooth was removed, the bone will continue to shrink over time. Dental implant therapy is indicated for replacing missing teeth since it serves two functions: it replaces tooth function and it preserves the jaw bone. Sometimes bone grafting and dental implant therapy are completed together following the removal of the tooth. That procedure is sometimes referred to as immediate implant therapy or single stage implant therapy – one surgical visit. Two stage implant therapy requires two surgical visits; first removal of the tooth and placement of the bone graft and a second surgical visit, dental implant placement, usually takes place 4 months later.

One common questions patients ask is, “Where does the bone come from?” This is a great question. The best source of bone is your own bone – referred to as an autogenous bone graft. Unfortunately, this is not readily available and harvesting it can cause more harm than good. The next best thing is human allograft bone – bone from another human. Bone allografts are processed in a few ways, here in our office, we use demineralized freeze-dried bone allograft which has been used for over 30 years without any disease transmission. Another source of bone is animal bone known as a bone xenograft. The last source is synthetic bone graft – a man-made bone graft matrix. Unfortunately, synthetic bone grafts don’t work as well as allografts. Allografts and autografts (human bone source) actually stimulate blood cells to differential into bone forming cells – xenografts (animal) are only a scaffolding no stimulation occurs. To date, they require more healing time and result in weaker bone formation. As technology continues to advance, so does bone grafting techniques, tools and procedures. These advances continue to enhance patient comfort and result in more predictable dentistry.