Bone Grafting/ Osseous Grafting
When teeth are lost, the bone that previously housed them begins to dissolve away in a process called “resorption.” Depending on the rate of resorption, the remaining bone may be insufficient to replace the missing tooth with a dental implant. If the missing tooth is to be replaced with a fixed bridge, the prosthetic replacement tooth may look artificially large if the bone and gum tissue have resorbed significantly.
One solution to this dilemma is to graft new bone onto the site. This process is sometimes referred to as “site development,” which refers to the fact that proper bony and gum contours need to be re-established before ideal tooth replacement can be done. There are several ways of performing a bone graft.
First, bone resorption can be prevented by packing the tooth socket with powdered bone graft material (called a “socket graft,” or “ridge preservation”) at the time of tooth removal.
Bone grafting can also re-establish the height (by a limited amount) and width of alveolar bone that has already been lost following removal of a tooth. A block cortical graft involves attaching a solid piece of bone to the deficient area, and attaching it with fixation screws while it integrates into position over several months.
Roots of the upper back teeth often project up into a hollow chamber inside the cheek bones, called the maxillary sinus. When any of those teeth are lost, bone may resorb from the sinus floor, as well as the other walls of the tooth socket. It can usually be regenerated in a procedure known as a sinus elevation or sinus lift.
Bony defects sometimes occur around teeth with multiple roots. Such areas can often be treated by guided tissue regeneration (GTR).