Bone addition

Bone grafting (bone augmentation) is a procedure that adds bone in areas of the jaw where it has been lost, so there is enough support for a dental implant. An implant needs bone that is tall, wide and strong enough around it; when bone is missing, grafting makes the implant possible and stable in the long term.

Why bone is lost

• after a tooth is extracted: without a root, the bone in that area gradually shrinks, especially in the first months;
• after many years without teeth, or with a removable denture pressing on the ridge;
• because of periodontitis, which destroys the bone around the teeth;
• after infections, cysts, injuries or difficult extractions;
• at the back of the upper jaw, where the maxillary sinus extends down and leaves little bone below it.

When you need bone grafting

The need for grafting shows when the implant is planned, on X-rays and usually on a 3D scan (CBCT), which shows exactly how tall and wide the bone is. The scans are done at an imaging centre, and the surgeon explains the result and the treatment options.

Types of bone grafting

• Guided bone regeneration: the graft material is covered with a membrane that protects the area while new bone forms.
• Bone graft: for larger defects, a block or particles of bone are used. Learn more about bone grafts.
• Sinus lift: raising the floor of the maxillary sinus and adding bone beneath it, for implants at the back of the upper jaw. Learn more about the sinus lift.
• Soft-tissue grafting: when gum is missing too, it can be rebuilt with a collagen matrix or a graft of your own tissue.

The materials we use

• Bio-Oss: purified bone mineral of bovine origin, used as a scaffold on which the body forms its own bone.
• NovaBone: a synthetic, bioactive material that stimulates bone formation.
• Autogenous bone: bone taken from the patient, from another area, for larger defects.
• Bio-Gide membrane: a collagen membrane that resorbs on its own and protects the graft during healing.
• Mucograft: a collagen matrix for rebuilding the gum.
• PRGF: plasma rich in growth factors, obtained from the patient’s own blood, which supports healing.

The surgeon chooses the materials according to the size and shape of the bone defect.

How the procedure goes

1. Planning, based on the imaging, and the consultation with the surgeon.
2. The procedure, under local anaesthesia, in the authorised surgery room; when indicated, under sedation with an anaesthetist.
3. Healing: the new bone needs a few months to form and mature.
4. The implant: in some cases, grafting is done in the same procedure as placing the implant; in others, separately, beforehand. The surgeon decides which suits you.

After the procedure

• Swelling and discomfort are normal in the first few days and are controlled with the medication your dentist recommends.
• Follow the prescription and instructions carefully: cold compresses, careful hygiene of the area, soft food.
• Do not smoke: smoking increases the risk that the graft does not integrate.
• Come to the scheduled check-ups so the surgeon can follow the healing.

Alternatives

When grafting is not possible or not wanted, there are sometimes alternatives: short or angled implants, or a denture on mini implants. The surgeon explains the advantages and limits of each option.

How much bone grafting costs

The cost depends on the size of the defect, the type of procedure and the amount and type of materials. Up-to-date prices are in the price list for implantology, and after planning you get a treatment plan with the full cost.