Patients needing dental implants often expect to have a new tooth, or set of teeth, after just one office visit. However, the tooth replacement process can take up to a year if other procedures, such as a bone graft, are needed first. We will discuss when a dentist may recommend a bone graft before implants so you can be prepared for what the procedure involves, as well as what to expect during recovery.
Rest assured, this procedure is a very common dental implant preparation step and will ensure your new tooth functions as it should and lasts as long as possible.
When is a Bone Graft Before Implants Necessary?
Unlike a crown that is placed over an existing tooth and its root, a dental implant serves as a total replacement for a missing tooth—root and all. To hold the implant in place as a natural root would, a dentist drills a metal post into the jawbone. Within 3-6 months, the post fuses with the bone — a process known as osseointegration. The jawbone must be sturdy enough to withstand this procedure. If the patient has experienced any bone loss in the jaw, it will be too unstable to hold the implant.
Jawbone loss can occur for several reasons, such as:
- Trauma or injury
- Missing teeth
- Periodontal disease
- Osteoporosis
- Aging
- Certain medications
To strengthen or rebuild the jawbone, a dentist can perform a bone graft, in which healthy bone is taken from the mouth or another area of the body and transplanted into the jaw. When a patient’s own bone is not healthy enough for the transplant, bone grafting particles from a tissue bank may be used. This extra bone material encourages the body to grow new bone cells in the affected area, making the jawbone stronger. About half of all dental implant patients require a dental bone graft.
What Happens During a Bone Graft?
Some bone grafts require minor oral surgery in the dental office, while more complex cases may need to be performed in a surgical center or hospital. Generally, a bone graft before implants involves:
- Anesthesia to keep the patient pain-free during the procedure
- A small incision in the gum tissue to access the area of bone loss
- Adding new bone material and securing it in place
- Placing a membrane over the graft to promote healing (in some cases)
The graft will gradually integrate with natural bone over the next few months, making the jawbone stable enough to hold the implant.
What is Sinus Lift Surgery?
If a dental implant needs to replace an upper molar, there must be enough strong bone in the jaw between the gums and maxillary sinuses to hold it. During sinus lift surgery, a surgeon cuts a hole in the gums, lifts the sinus membrane, and inserts bone or bone-like material between the sinuses and the jaw. In some cases, the dentist waits for the bone to grow and strengthen before placing the implant. In other cases, the implant is placed at the time of the sinus lift surgery.
A dentist will recommend sinus lift surgery in several scenarios:
- The patient’s jawbone is naturally small and not sturdy enough to support the implant
- The patients’ sinuses are too close to the jawbone
- After tooth loss of the upper molars, the space remained empty long enough to allow bone loss
- Gum disease has gone untreated and led to bone loss in the jaw
What Happens if I Don’t Do the Recommended Bone Graft?
If a bone graft or sinus lift is deemed necessary, most reputable dentists will refuse to perform implant surgery without first performing the grafting procedure. This is because complications with the dental implant would be imminent, including:
- The implant may not fuse properly with the jawbone, leading to instability in the teeth that makes it difficult to speak or chew.
- Pain and inflammation in the gums due to the implant rubbing against them. The implant may even pierce through the gum tissue.
- A need for extensive dental surgery down the road.
What Can I Expect from Implant Bone Graft Recovery?
After bone graft surgery, it’s common to experience some swelling, discomfort, or minor bleeding. If a sinus lift was performed, you may experience some bleeding from the nose. Your dentist or oral surgeon will recommend:
- Pain medication such as ibuprofen
- Ice packs to reduce swelling and ease discomfort
- A soft or liquid diet for the first two to three days
The dentist will schedule a follow-up appointment to monitor progress and ensure that the bone graft is healing properly. After three to nine months, the jawbone will have grown strong enough to stabilize the implant.
Not Sure if You Will Need a Bone Graft Before Implants? Ask a Dentist You Can Trust.
If you do not have a clear understanding of the implant procedure or feel nervous about getting a bone graft before implant surgery, you’re not alone. Many patients are confused about the timeline for dental implants. The good news is that your dentist should be able to clear up your concerns so you can feel confident, and even excited, about the procedure. After all, you will be walking away with a beautiful new tooth!
If you don’t feel comfortable asking your dentist questions or would like a second opinion, you can make an appointment with one of our dentists near you now.