Periodontal Bone Graft

3d rendering of a dental implant used in place of a bone graft

Most cases of periodontal disease are treatable using minimally invasive procedures, such as scaling and root planing or gum surgery. However, a periodontal disease that has been allowed to progress can result in deteriorated bone beneath the gums. When bone is destroyed by gum disease, it can no longer adequately support the teeth, eventually leading to total tooth loss. In these cases, a periodontist may recommend bone grafting – also known as regenerative surgery. During this procedure, a prepared graft is placed in the areas where bone should be, which encourages the body to rebuild the areas lost to periodontal disease.

Bone grafts are derived from one of four possible sources: the patient, another human being, an animal or synthetic materials. The source used will depend on whichever the dentist believes will work best in the patient’s situation. Donor tissue from another person or animal is thoroughly disinfected and safe for grafting.

The graft itself acts more as a platform for nearby bone to grow upon; the new bone growth will eventually replace the graft material. The dentist may also cover the graft with collagen membranes to guide the regeneration, or synthetic material that acts with other biologically active molecules in the body to promote healing. These materials are eventually absorbed by the body.

Not all grafting procedures are alike—the particular approach taken will depend on the location in the mouth, the degree of bone loss, and whether the grafting takes place immediately after removing a tooth (extraction) or if some time has passed since tooth loss.

In the case of tooth extraction, one option would be for the dentist to fill the site with bone-grafting materials after removing the tooth and before suturing the gum in place. Immediate grafting can limit bone loss during gum healing and facilitate a future dental implant procedure. If the tooth has been missing for some time and the remaining bone is insufficient, the dentist will make an incision in the gum tissue to expose the bone, place and secure the graft along with any planned membranes or growth factors, and then suture the incision closed. Procedures like this are usually performed with local anesthesia.

After a grafting procedure, patients may experience only mild discomfort for a few days, usually managed with anti-inflammatory, non-steroidal medications like ibuprofen. As a precaution against infection, an antibiotic may also be prescribed

Did you know…

that periodontal bone grafting is not just for advanced periodontal disease patients? In fact, more and more patients are undergoing bone graft procedures to gain enough bone structure to support dental implants. Bone beneath the gums naturally deteriorates following tooth loss. Bone grafting rebuilds these ridges and makes it possible for many patients to get permanent tooth prosthetics instead of dentures.

Frequently Asked Questions

Will I need periodontal bone grafting?

The only way to know if you are a candidate for periodontal bone grafting is by scheduling a consultation with your periodontist. An exam will reveal the condition of your teeth, gums, and the supporting bone beneath. Based on your evaluation, your periodontist will make a recommendation for treatment.

What should I expect during a periodontal bone graft treatment?

If bone grafting is the right treatment for you, you’ll visit your periodontist’s office, where you may undergo a scaling and root planing treatment to remove disease-causing bacteria and help prevent additional complications in the future. Prior to the grafting procedure, you’ll be given a local anesthetic to minimize procedural discomfort and possibly sedated for your comfort. The gums will be separated from the teeth, and a graft placed near the underlying bone. A synthetic or organic barrier will be used to ensure the gums do not grow into areas the regenerated bone will eventually occupy.

Will I need to follow any special instructions following a bone graft procedure?

Yes. Bone graft surgery will leave you with sore and swollen gums, so expect to eat only soft foods in the days following your procedure. You may be given pain medications or antibiotics to be taken according to your periodontist’s instructions. It may take up to nine months for your body to make new bone to fuse to your graft.

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