Bone grafting

Bone grafting is a type of surgical procedure in which bone lost to disease or atrophy is regenerated with state-of-the-art biomaterials.

Bone Grafting

Bone grafting is a type of surgical procedure in which bone lost to disease or atrophy is regenerated with state-of-the-art biomaterials.

Table of Contents

What is bone grafting?

Bone grafting is performed for many different reasons and situations, but the common element is that bone is regenerated with the use of a scaffold, which is usually allograft (cadaver bone), xenograft (from other animals, usually bovine/cow), or autograft (from yourself) and covered with a membrane. bone grafting can be performed around natural teeth to regenerate bone loss from periodontal disease or around implants to treat peri-implant disease. Bone grafting can be completed at the time of tooth extraction to preserve the volume of the existing bone (often called socket grafting or ridge preservation), or to grow bone in deficient areas to help support a dental implant (also called ridge augmentation). It also can be performed in the sinus cavity to create vertical space for implants (often called sinus lift, sinus augmentation, or sinus grafting).

Bone graft material can come from many sources. We specialize in using non-autogenous bone, meaning not sourced from yourself, in order to minimize the surgical morbidity seen with harvesting your own bone, usually from an additional secondary surgical site. We typically use allograft, donated bone from human cadaver and/or xenograft, bovine bone particulate from cows. Your safety and comfort is a priority for us. The allograft we use is sourced from LifeNet Health, the worldwide leader in tissue implants, to ensure the highest quality of processing and sterility. The bone graft we purchase is crushed and comes in small pieces, only 0.25-1 mm in size, and is sterilized of all active cells and only acts as a scaffold or placeholder to tell your body to send bone cells to the area. The bone graft we place is dissolved and resorbed by your body – by 3 months more than 80% of the graft is dissolved away and replaced with your own natural bone.

What you should know before your Bone Grafting in Orange County

Before any bone grafting procedures are performed, you will need to have a consultation with us. In order to properly evaluate the anatomy, a 3D or CBCT scan (cone beam computed tomography) is needed to assess the available bone, vital structures, location of the sinus cavity, etc. Depending on what the final goal is, and what your current anatomy looks like, we will devise a surgical plan to safely regenerate the bone needed. We strive to minimize the number of surgical procedures and appointments needed – meaning if a dental implant is part of the final plan, we try to plan on doing the implant and bone grafting at the same time. 

What happens during your Bone Grafting procedure?

What kind of anesthesia is used?

Most of the time, we do bone grafting procedures under local anesthesia. The area is numbed just like any other dental procedure. We also offer two additional sedative options. An oral sedative or anxiolytic can be prescribed for you to take an hour before the procedure, which will help calm you down and make you drowsy during the procedure. You may or may not remember the procedure afterward. Another sedation option we offer is “twilight” anesthesia. A board-certified dental anesthesiologist will administer medication through an IV line to make sure you are safely sedated and asleep during the entire procedure.

The surgical procedure

The procedure will depend largely on what situation the bone grafting is being performed. For more specific procedures, please see the page for bone grafting around natural teeth, bone grafting around diseased implants, and sinus lifts. In the simplest cases, a tooth can be removed, and bone graft is placed in the socket and covered with a membrane. In more complex cases, an incision is made and the gums reflected from the bone. Bone graft is placed in the area we are augmenting and covered with a collagen membrane. The soft tissue is carefully stretched so it can be closed over the new larger volume. A dose of anti-inflammatory steroid is given to minimize swelling.

How long is the bone grafting procedure appointment?

Because of the vast differences in case types and procedures, it is hard to say exactly how long the appointment will be, but appointments for bone grafting procedures can usually range between 1.5 hours to 3 hours. 

Bone Grafting recovery and results: what to expect

After the anesthesia wears off, you may be sore or experience aching in the area. Any discomfort can usually be resolved with ibuprofen (Advil) or acetaminophen (Tylenol). Stronger pain medications are rarely needed but can be prescribed depending on your pain sensitivity. In bigger bone grafting cases, you may have some bruising or swelling from stretching your tissue. Most of the swelling occurs in the first 72 hours before slowly getting better. Usually after a week most of any post-operative swelling will have resolved. We recommend no heavy lifting or exercise for at least the first 72 hours. Most patients can return to work the next day.

Stitches are dissolvable, but depending on what kind, some may fall off after a week and some will stay longer. If they are still there at the post-operative visit, we will remove them for you.

It is important that no pressure is placed over the graft especially during the first 3 months of healing, otherwise the regeneration may become compromised. Bone regenerates on average of 1 mm per month, so depending on the amount of bone grafting that was performed, we usually wait 4-6 months for the bone to regenerate and mature. If dental implants are needed to be placed in the jewelry regenerated bone, it will take another 3-4 months for the implants to heal. If implants were placed at the same time as the bone grafting, then they will be ready for the final restoration.

Our team of periodontists specialize in bone grafting procedures, and serve the communities of Orange County, including Orange, Anaheim, Fullerton, Anaheim Hills, Tustin, Placentia, Yorba Linda, Santa Ana, Villa Park and Garden Grove. Book your consultation today!