Extractions and Bone Grafts

What are Extractions and Bone Grafts?

Bone grafts can often become necessary in an number of different dental situations, and in fact there are three common types of bone grafts and a half-dozen or so reasons for needing one. Here we will focus on the two most commons reasons for dental bone grafts.

Bone Grafts After a Tooth Extraction

The most common reason for a dental bone graft is to prevent bone loss following a tooth extraction. These are called “socket grafts” because the bone-graft material is inserted into the empty socket left by the extracted tooth.

Specifically, it is your alveolar ridge (along with periodontal tissue) that will shrink down in the months and years following tooth loss or tooth extraction. Your body actually allows resorption of the bone material when it no longer receives the day to day stimulation exerted by an active tooth or dental implant.

A large portion of bone resorption takes place within 3 to 6 months of tooth removal. The vertical aspect of your bony alveolar ridge (attached to your jawbone) tends to disappear faster, but the horizontal aspect (width) can also shrink.

Studies have shown that sockets that get bone grafts, and relatively quickly after the tooth extraction, end up losing over a millimeter less ridge bone height and over 2.5 mm less bone width. That may seem small, but the fact is that even one or two mm extra bone height/width can make a big difference if you ever want to get a dental implant. It could make bone graft surgery unnecessary before getting implants and make the operation less painful.

Do all extraction sockets absolutely need a bone graft? The answer is no. But, many of them do, especially if you have a lot of soft tissue missing, such as when you have serious periodontal disease. Or, if a significant amount of bone is already missing from your alveolar ridge, you should get a bone graft right after any extraction.

Bone Grafts Before Receiving Dental Implants

The first common reason to get a dental bone graft is because you just had a tooth extracted, but the second major reason is because you are preparing for dental implant surgery.

There are a number of reasons why you might lack adequate bone structure to support an implant. These include:

  • Genetic of developmental defects.
  • The ravages of untreated periodontal disease.
  • Physical injury to your jaw due to falls, contact sports accidents, or automobile collisions.
  • Deterioration of bone mass after earlier tooth loss or tooth extraction.
  • You recently lost a tooth and the socket is infected or is the wrong size for the implant root.
  • You have worn removable dentures for years, and they have gradually worn down your alveolar ridge.

Whatever the cause, if your bone is not sufficient to support the implant root, you will have to undergo bone grafting before the implant(s) can be installed. It could take anywhere from 3 to 6 months for the bone graft to fully heal and integrate with existing bone and new natural bone growth.

Thus, getting a bone graft right after a tooth extraction can often (but not always) avert the need for bone grafting just before dental implant surgery.

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