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Bone grafts in periodontics

There are various types of bone grafts that can be performed in the periodontal office.
1. Guided Tissue Regeneration- bone grafting around an already existing tooth which has lost bone due various problematic issues. The bone grafting procedure consists of opening the gum around the tooth, cleaning out the defect, adding bone and a resorbable membrane and closing the gums tightly around the tooth with suture. The bone takes about 6 months to grow back around the tooth. This technique has been around for 30 years and is effective in saving certain teeth.
2. Guided Bone Regeneration- bone grafting of a tooth socket AFTER extraction of the tooth in question. The socket bone is regenerated because an implant may be planned as tooth replacement in the empty tooth site. After FOUR months, the extraction site is x-rayed and assessed for a dental implant and crown placement.
3. Bone Block Graft- when there is enough vertical hight of bone to place a dental implant but not enough HORIZONTAL bone, then a bone block graft is placed on the ridge and stabilized with at least two stainless steel screws. The screws are left in position for four months. Once an x-ray is taken after four months, the site is assessed for a dental implant. Once it is decided to place a dental implant, the gum is opened and the stainless steel screws are removed. Finally, a titanium implant is placed in position. Three months later, a crown can be placed.
4. Sinus Lift Procedure- when someone loses an upper molar, there may be extensive bone loss such that implants may not be possible UNLESS a bone graft is performed. Such a bone graft procedure is called a SINUS ELEVATION (LIFT). The gum is opened, a window is created on the lateral aspect of the upper jawbone and bone grafting material is used to fill the sinus site. If there is at least 3-4 mm of bone, an implant may be stabilized at the same time as the bone grafting procedure. Dental implant crowns may be placed at 4-6 months. Otherwise, if there is less then 3-4 mm of bone, the bone graft is performed and then 6 months later, the implants may be placed. Three months later, the crowns may be placed.

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