Worried About Bone Graft

Jane, a dental implant patient, ask us:

I am getting two dental implants soon. Tooth # 29 has to be extracted, and tooth # 30 has been missing for many years. The dentist told me that I would need a bone graft done in # 30.

He said he’d be able to do the tooth extraction, the bone graft and the dental implant at the same time in one visit. Laser will be used. I will then have to wait for about 4 months, and have post operative visits to see the progress and determine when the crown and the abutment can be placed.

Does anyone have any advice about the bone graft? I am terrified of the idea of getting the bone graft, as I have heard quite a few stories that were not so good. What kind of graft should I be getting? What should I be looking out for? Why do these grafts sometimes fail? Any professional help in alleviating my anxiety would be much appreciated. Thanks very much.

32 thoughts on “Worried About Bone Graft

  1. Good question in light of recent events involving human tissue grafts. The most widely used and tested bone graft materials are bovine material (Bio-Oss). Unlike human, this material is FDA approved and have never been linked to problems with processing etc… Your DDS is fimilar with this product and can order it for your procedure. Hope this helps, it is all we use in our perio practice.

  2. We have been using for the past 5 years a mixture of human bone (Grafton Putty from Osteotech ) and bovine bone ( BioOss from Geistlich )with great results and no problems. Recently we started using a mixture of Grafton Putty + MinerOss, both from Ostetech.There is a synergy between the two products since one is osteoconductive and the other osteoinductive.

  3. In reference to the previous message who uses Grafton and Mineross products. True they are produced by Osteotech yet they are distributed by BioHorizons Implant Systems.

  4. Synthetics are the future the more they are used the better the results, with safety and reduced patient concerns.I have only used synthetics for the last 2 years and I as well as the patients are happier

  5. Mixing Grafton with Miner-oss is a great idea. It provides induction from the Grafton and architectural support from the Miner-Oss. My question is why would you want to have to combine two materials when there is a product that gives you both of these components? OrthoBlast is demin and cancellous min bone in a paste form. Very easy to use and has been working well for many years for me. And as far as the FDA, it received approval to market from the FDA earlier this year. Also, for particulate grafting cases, I have started using a product called Nu-Oss which is a generic Bio-Oss. LOTS less expensive and the same stuff.

  6. I would like to know some opinions on the teflon membranes. My Dentist wants to use one of those and Bio-Oss for my implant treatment. I personally would prefer a resorbable pig collagen membrane, but was told it might collapse where the teflon one would hold it’s shape since it’s titanium reinforced. I am concerned about the possibility of carcinogens from the teflon. Also, who knows if you might contract mad cow disease from the cow bone used in Bio-Oss. I would prefer pig bone. I heard it was in the works, but probably won’t be approved for use in the U.S. until 2008. Has anyone else heard about this?

  7. Regarding the Teflon membrane it does maintain the space required for bone to grow unlike the collagen membrane yet it needs better surgical skills and maintains possibility for infection if it gets exposed.

  8. First, What is in the synthetic materials to make the body`s bone to grow. Nothing, the histological results always shows the allograft to be the best.
    Allograft is SAFE.

  9. Allografts make “the body grow bone”? At best it is a poor filler material that is neither osteoconductive or inductive. It is old school dentistry that is seldom used in progressive markets. Also, regarding an earlier comment…there is no such thing as generic “Bio-Oss”. Check out the SEMs for proof and /or ask for products clinical studies and histology. Lastly, synthetics are the trend for for some procedures. I have seen great bone in extraction sockets four months after extraction.

  10. I have had 2 implants placed in the lower arch (at the back) which are now almost 11 years old. They have functioned very well indeed but over the past couple of months or so, I have lost a tiny little bit of confidence in them in terms of chewing certain foods (say crisps). I don’t know whether this is because there has been some bone loss (the implant is more visible now than it used to be), whether the gum has receded a little or whether it is just my own concern which is unfounded.
    I would be interested to hear from people who have had implants in the back of the lower arch for over a decade and whether they have had any issues? It’s as if saliva can get in between the implants when you place your tongue there and the visibility of the titanium is just a little bit more pronounced these days.

    To the experts : should I have this looked at and is this a prelude to future problems with the implants or is this normal?

    Do you have any idea how long my implants are likely to last?

    I was told by my dentist that they should last ‘a lifetime if looked after properly’. Is there anyway that I can improve the way that I floss them or look after them?

  11. My dentist kept 2 of my wisdom teeth in when I had the other 2 extracted. The dentist said that they might be useful in the future – my question is whether it is possible to extract a tooth and use a wisdom tooth to replace that tooth by attaching it to the root?

    I just wondered whether the wisdom tooth has any additional use?

  12. jerry,
    bovine materials are not much different from allografts when it comes to rejection .Remember the same principles of rejection & infection apply to most graft materials.

  13. can anybody provide me with informations about cerasorb m bone graft material?is it as good or comparable to grafton + biooss?

  14. I’m not confidence when Ido implats on a graft area .
    I had use a lot of grafting materials , and I still fill not secure.

  15. The middle of August I had #5 (2nd tooth from top left right under my nose) removed because a crown with pin on a root canal had shattered. Bovine material was implanted and I am supposed to have a screw and tooth implanted there. I am realizing now that I might be having some kind of reaction to the bovine material because three weeks after the surgery I had a “silent” migrane while shopping with my husband. He took me to Emergency and everyone thought I had suffered a stroke. I had complete loss of memory, slurred speech and did not know my husband or my surroundings for 8 hours. I had a MRI and CAT scan (no stroke). I am now on 100 mg of Topamax daily, I lost my job, my nose is cold and sometimes runs. The last two nights I have awakened with a feeling of numbness in my lip and feel like I have a tooth ache in that area. Because I am still suffering from short term memory loss, I am just now remembering the dental procedure and wondering if I should mention this to my doctors/dentist before proceeding this month with the screw? Could this procedure be the cause of the migrane? I am very sensitive to preservatives and the Bovine material is very close to my brain.

  16. The bovine material doesn’t contain any protein contents or prions which can cause allergy or BSE. It is just the mineral contents that are left which function as a frame for your bone-cells. You should always mention these problems to your dentist. It looks like ( because your nose is feeling cold and running sometimes) thatyou deal with a sympatic / parsympathic problem, but there are many opions: epeleptic desease, Nervus vagus problems,orofacial problems, transient global amnesia, etc, etc, etc. So maybeyou can let yourself referto a team of specialist to do a whole check-up. Good luck

  17. Mya,
    Cerasorb is a synthetic. I believe it is a Beta Tri-Calcium Phosphate. Grafton & BioOss are cadaver & bovine based grafts. With Cerasorb, you are not relying on donor bone quality nor do you have to worry about disease transmission or immunologic reactions. Cerasorb is also the only synthetic that is FDA approved for all dental indications and the studies have proven that Cerasorb produced much more vital bone growth than BioOss & Grafton. Just ask yourself if you want cadaver bone, cow bone or a synthetic calcium in your mouth and that should give you your answer. I hope this helped.

  18. I just had bone and tissue grafting done for both of my incisor teeth five days ago. I have been missing them all of my life. I was not able to get the implants at the same time as this surgery because there was not enough bone. That is why I had the grafts. I had my wisdom teeth out at the same time so they took the bone for the graft from those spots on my jaw. They also took tissue from the roof of my mouth and from above my canine teeth. It has been a fairly painful recovery, and my face is pretty swollen, but I know it will be worth it eventually. Good Luck with yours.

  19. James, how is your recovery going? I too have had quite a painful recovery from implant and bone graft surgery. Any feedback would be appreciated.

  20. i plan on having a bone graft on tooth #31. the periodontist was going to use bovine/swine bone, i said no can do. i do not believe in using animals for anything if i can do so. so they will use a synthetic material. what is this material? is it just as effective as animal bones? is there pain and discomfort? if so for how long? when will normal eating return to the area that is being worked? generally, how long does it take for total restoration? finally, when i had my wisdom teeth and my other molars removed should the bone filler had been injected into the missing teeth area? thanks, dave

  21. Dazed and Oh so Confused!
    I have been to 3 Dentists and Periodonists who specialize in inplants. In my case- I have to remove 5 front teeth which scares me. My teeth are beautiful but the bone wont hold them. The first 2 doctors recommend that i get the teeth extracted, bone grafted and then screws put in then the implant. The entire process will take approx 1 year ( approx $53,000) the other young high tech doctors says that he can do it all in one day and for less the money (approx $20,000). The opinions are so different- the one day treatment really appeals to me-however the opinions are so different. Is the new technology going towards the condensed treatments and does the bone heal well?

  22. Tracy, Onlay bone grafting has at best a 50% chance of success. If you do not smoke, extract the teeth, wear a provisional (flipper), revisit in about 6 mo. Then look over the situation. Consider a segmental osteotony w/ interpositional graft and then implant. This will probably give you superior results and with less risk. And not at $53,000.00!

  23. segmental osteotony w/ interpositional graft and then implant, how much time does the extractions, grafting and the above take? What happens if i do smoke?

    What about a bridge?
    I really appreciate your advise. Tracy.

  24. Has anyone, professional and/or patient, seen positive results for a bone graft from patients’s own tibia, which I have been told is richer in bone marrow and yields better results than bone drawn from jaw area?

    Also, to what degree does the success of the bone graft have to do with the surgeon, i.e., does it matter if the surgeon is also a plastic surgeon, or oral maxillary surgeon, or is it better to have a surgeon who is also a periodontist? Are these major or minor distinctions?

    All your comments are most appreciated.

    Thank you.

  25. I have a question about the Bi-Con system.
    How does it compare with the NobelBioCare system?
    I need an implant in the second premolar area max. right side. I have heard horror stories about loose abutment head screws and apparently the Bi-Con is a tap-in system that eliminates the screw.

    Any comments from folks who have used both?
    Are they equally as good as far as withstanding bite pressures etc,?

  26. Linda, The Bicon Implant is a great implant in the posterior (back part) part of the mouth. Used singly in the anterior (front), you can have probleme with the abutment getting loose, if the implant is less than 4 mm. wide. Otherwise it’s a great implant. Most of the implants on the market are excellent. You just have to find what pleases you.

  27. With a bone graft using bovine material, that area is turning brown where my gums and teeth meet. Is that normal? I had my surgery over a year ago.

    Thanks!

  28. I just had a bone replacement graft and osseous surgery on my lower right quadrant two months ago. I now feel one tooth (next to canine) is wiggling and has gum recession from the surgery. I am very concerned. May I get any idea why my tooth is wiggling? Thanks.

  29. I had a tooth extracted two days ago and place bone graft. The dentist just place bone in the hole which my tooth #14 extracted without membrane and suture. After 3 hours, bone lose, and went to see dentist again. He took this bone, and put it back with suture without membrane. Yesterday, bone lose again, he put back this bone.
    Will the bone graft be successful? He did bone graft without suture and membrane, is he not right?
    Thanks a lot.

  30. I have had a 75% failure rate with 4 implants placed in my upper jaw front teeth. My surgeon said he was trying to save me from needing bone grafts. I have changed oral surgeons. Now I am seeing someone who believes that I need bone grafts to have successful implants. Will a bone graft help both quantity of bone and quality? What should I do? My original surgeon wanted to keep trying implants.

  31. Is synthetic material better than bovine for jaw bone grafts?
    What are the pros and cons of each? Which material is used more often?
    Does synthetic or bovine promote more bone formation? Or do they work about the same? Does one or the other have a greater success rate? Less complications?

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