BONE GRAFTING

If you're considering dental implants, then you should know that there are certain instances when an implant cannot be placed immediately into the jawbone simply because there isn't enough bone to firmly support the implant. If, in this case, the implant is placed anyway, it may not be able to ossify or heal properly and this can lead to either a short- or medium- term implant failure. To prevent this situation from occuring, a procedure called autologous bone augmentation is commonly performed by a dental surgeon. Autologous bone augmentation means that bone is extracted from an area of the patients own body - like the jaw, skull, hip or chin bone - and then directly grafted into the area where the implant will be placed. The result is a strenghthening of the bone where the implant will be placed and better aesthetic results giving a more natural look - especially in the frontal area.

Since a bone augmentation needs time to heal properly, it can take up to 6 months or more for a section of bone from the patient to bond with the jaw bone itself. After the healing time has passed and the new bone graft has fully bonded to the jaw bone, the titan implant can be securely anchored. The surgery itself can take up to 1 to 2 hours and is performed with either a local or general anesthetic to minimise any discomfort.

Once determined with a CT scan or Xray that a bone augmentation is needed, an anesthetic is given and the area will be prepared for the procedure. Bone is commonly taken from the lower jaw but in some cases other areas including the hip or calvaria (even the shin!) The gum is opened from the area covering the missing tooth and this determines how much bone material will be needed to graft into the area. After the bone graft is removed from the donor location, it is placed into that tooth space and then closed and sutured over with the gum.

1. What are the benefits of autogolous bone augmentation?
   The most important benefit to having bone augmentation is the restoration of bone so implants can be placed securely. Bone augmentation is a safe and reliable method for assisting the anchoring of implants and thus teeth into the jawbone when initially there is a lack of bone or bone resorption. The results are more natural looking - especially in the frontal area.
   
   
2. What are the dangers or complications to bone augmentation?
   All surgery involves a small degree of risk and bone augmentation is no exception. Improper dental care following the procedure can be one of the main causes of either a bone rejection or infection in the area.
   
   
3. Will my face be swollen after the surgery?
   Immediately after the procedure, it's common to have swelling and a little bleeding which should subside within the first 24-48 hours. No cause for alarm. The use of ice packs will also help to keep the pain and swelling down and expedite healing. Painkillers will be prescribed by the doctor.
   
   
4. Can other materials be used in place of my real bone?
   Some dentists use a variety of substitute materials to simulate bone for augmentation. These materials have also been proven to be useful but nothing is as reliable as the patients own bone. The bone extracted contains living bone marrow which makes for a better, faster transition and thus the best choice. The healing of a graft of a patient's own bone occurs more naturally, better and leaves less of a chance for any type of bone rejection.
   
   
5. Does having a bone augmentation hurt?
   Not at all, you're given an anesthetic that numbs the entire area in which the procedure will be performed. In most cases you can even be given a full general anesthetic so as to comfortably sleep throughout the procedure. After the surgery, the doctor will give you painkillers and antibiotics. A compression bandage may be placed around the head for a few days recovery and mild discomfort for the first few days can be expected.
   
   
6. Why does it take half a year (4-6 months) before a crown can be placed?
   Depending on your overall health and the amount of work that has been done, the healing times can vary. Bone in the jaw needs to heal just in the same manner as a broken arm or leg would heal - as time passes, the bone graft will fuse with the original bone which now becomes the new surface area where the implants will be anchored.
   
   
7. Will the bone augmentation ever fall out?
   The chances of rejection or graft failure are higher when synthetic bone materials are used – not with autologous bone augmentation. This can be due to the fact that blood vessels may find it hard to grow through the synthetic material and, thus, can delay or impair the healing process. With autologous bone, the body identifies the bone graft as being from the same body. Thus, it is accepted immediately as being a part of that bone tissue. Once healed, the augmentation will be a permanent part of your own bone.
   
   
8. How long before I can return to work?
   Thankfully, the procedure can be done in one day and you will be able to return to work after 5-7 days of recovery. There is no additional follow up needed and you can depart from Hungary just a few days afterward.
   
   
9. Are there special foods I must eat after the bone augmentation surgery?
   There are no special dietary needs after a bone augmentation though your dentist will advise not eating certain foods for the first 24 hours, liquids will be the best choice in that post-op time. Chewing on a side of the teeth where the bone augmentation has been placed should be avoided for about 2 weeks as excessive pressure from chewing can disrupt or break the stitches placed in the gum. Soft rinsing with a cup of water mixed with ½ teaspoon of salt or baking soda after eating is advised as well to keep any and all food particles out of the healing gums.
   
   
10. How long does the surgery take?
    The surgery time depends on the amount of bone augmentation required. It can take up to an hour or two, no more. Although the procedure itself is not long, the healing time can vary from patient to patient – approximately 6 months.
    
    
11. Am I a good candidate for autologous bone augmentation?
    Nearly everyone who has good health but simply not enough bone structure or bone density in the area where a dental implant needs to be placed is considered a good candidate for Bone Augmentation. A consultation with your dental surgeon will help determine the best solution for being a perfect candidate since bone augmentation can replace missing teeth where they couldn't be placed before or relied on dentures, bridges, or other uncomfortable dental work previously done in the past. People who are not considered good candidates are heavy smokers and/or heavy drinkers (mainly due to the longer healing time), diabetics, and/or patients with auto-immune deficiencies.