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Bone graft

The need for these procedures are due to the deterioration of the natural jaw and gum tissue after tooth loss. Once a natural tooth is lost, the underlying bone is no longer protected or stimulated, and will begin to recede and weaken.

There are various bone graft methods

  • Bone particulate graft - used for guided bone regeneration usually in combination with a membrane keeping it in place.

  • Bone block grafts - a block of bone is used to graft the deficient area.

What happens before bone graft surgery?

If you're getting bone graft surgery, your dental professional will first determine where they'll get the extra bone. The three most common types of bone used in bone graft surgeries are:

  • Autogenous bone: bone from your own body

  • Alloplastic bone: synthetic bone

  • Xenograft: bone from a cow

 

If the bone comes from your own body, it will come from other areas of your mouth.

You'll then need to get X-rays taken. X-rays allow the surgeon or dental specialist to study your jaw and sinuses so they can figure out precisely what you need.

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Guided bone regeneration procedure with bone particulate

Now, we'll go over what you can expect in surgery so that you're fully prepared and confident as you go into your particulate bone graft procedure. Here's a general sequence of events that take place during guided bone regeneration surgery:

  1. The surgeon cuts the gum tissue.

  2. The tissue is raised, exposing the  deficient bone underneath.

  3. The surgeon drills small holes in the surface of the bone.

  4. The bone particulate is placed onto the planned area and is sometimes covered and kept in place with a membrane and small pins.

  5. The surgeon closes the incision.

  6. The healing process begins.

 

In about 4-12 months after your particulate bone graft procedure, your implants may be will placed. This time in between gives the new bone time to merge correctly with your existing bone. The amount of time between your surgery and getting your implants placed depends on how much bone you needed. Your dental professional will let you know when they'll be able to place your implants.

This procedure can also be done simultaneously with implant placement if there is enough bone to stabilize the implant sufficiently.

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Bone block graft procedure

Now, we'll go over what you can expect in surgery so that you're fully prepared and confident as you go into your bone block graft procedure. Here's a general sequence of events that take place during bone block surgery:

  1. The surgeon cuts the gum tissue exposing the area to be grafted.

  2. The gum of the lower jaw is cut in the area next to the wisdom teeth.

  3. The tissue is raised, exposing the bone that will be removed in the shape of a block that measures to fit the area that will be grafted.

  4. The surgeon removes the bone block by cutting into the bone, then fracturing it out with a chisel.

  5. The surgeon closes the incision.

  6. The bone block is placed onto the planned area and secured in place with small bone screws. Small voids are filled with bone scrapings.

  7. The surgeon closes the incision.

  8. The healing process begins.

 

In about 4-6 months after your bone block graft procedure, your implants may be will placed. This time in between gives the new bone time to merge correctly with your existing bone. The amount of time between your surgery and getting your implants placed depends on how much bone you needed. Your dental professional will let you know when they'll be able to place your implants.

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What to expect after bone block surgery

Swelling

 

  • You can expect to swell to some degree, this is normal and is nothing to worry about.

  • The swelling usually reaches a peak in about 3-4 days so do not worry if it continues to swell.

  • Use of ice packs for the first 48 hours and application of moist heat after 48 hours can minimize the swelling. Please post-operative instructions section for more detail.

  • If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. 


Bleeding

 

  • Oozing is normal and when this mixes with your saliva it may seem excessive, but it is normal and can persist for a day or two.

  • When thick, red clots form, let us know immediately so we can advise you.

  • A wet cotton wool ball can be used to bite on. The pressure should be applied for 5 – 10 minutes and this will help control most bleeding.


Pain

 

  • The amount of pain that you feel varies from patient to patient. There is usually very little pain involved in all surgeries but if you do have a lot of pain it may indicate an infection and should be checked.

  • Taking your medication will take care of any/most discomfort.


Bruising

 

  • Bruising over the face, eye, and neck can occur and is nothing to worry about.

 

Altered sensation

 

  • Also known as paresthesia and may be experienced as a burning or prickling sensation. A feeling of numbness may also be temporarily felt after surgery in the bottom lip and cheek area.

  • This is usually due to the pressure of tissue swelling in the surgical site where the bone block was harvested and is usually temporary.

  • If the altered sensation persists unchanged after 4 weeks.

 

Diet and chewing

 

  • For the bone to heal around the implant it needs to be stable and has no movement. You may not chew on the area where the bone and implants have been placed until they have been checked for integration. This can take anywhere from 4 – 12 months.

  • It is also essential to eat a soft diet during the healing time. Eating hard food will put pressure on the healing wound and may lead to either opening of the wound or early load of the implant which may cause it to fail.

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Post-opertative instructions

Rinsing

 

  • Mouthwash should be used regularly to lower the chances of infection,

  • Do not dilute the mouthwash, it is to be used twice a day 30 minutes after brushing teeth. Rinse your mouth for one minute then spit out.

  • Do not rinse, brush, or eat for at least an hour after using mouth wash.


Medication

 

  • If antibiotics are prescribed, please use it as per prescription instructions.

  • Anti-inflammatory painkillers are important to reduce the level of discomfort as well as to reduce the swelling. These must be taken even if you do not feel any discomfort. Take 2 tablets/capsules immediately after surgery and then two tablets 4 – 6 hourly thereafter.


Other instructions

 

  • You must eat soft foods like soups and yogurts etc. for at least one week.

  • Use of ice packs for the first 48 hours can minimize the swelling.

    • The ice packs provided by our office (or bags of frozen peas) should be applied to the sides of the face continuously while awake where surgery was performed.

    • After 48 hours, ice has no beneficial effect, then moist heat can be applied to the respective area.

  • No exercise for at least 3 days.


Tooth brushing

 

  • Avoid the surgical area with a toothbrush for 10 days.

  • Start brushing gently as soon as you can.

  • Brush all other areas that have not been treated and try to dislodge any food that may be sitting in the area of the surgical site.

 

Dentures & Prostheses

  • Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise.

  • When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the graft.

* This list serves merely as a guideline should you encounter any of these complications. Please call us if anything worries you. We will easily
be able to put your mind at rest.

Get in Touch

078 972 2702

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