Also called regenerative surgery, a bone graft is used to recreate bone and soft supporting tissues lost due to periodontitis. If you have periodontitis, you may be losing bone support around your teeth, and in order to avoid extractions, your oral surgeon may recommend regrowing the lost bone with a graft.
The goal of bone grafting is to encourage the body to rebuild the bone and other structures that attach a tooth to the jaw. First, your oral surgeon will separate the gums from your teeth in order to gain access to the roots and bone. The roots will be thoroughly cleaned, and the holes in the bone will be filled with a graft material that usually consists of your own bone. After this process is completed, your periodontist will put the gums back in place and stitch them together. Over the next few months, the grafted material will be encouraged to grow, which will fill in for lost bone and soft tissue.
A common use of bone grafting is for ridge augmentation. Ridge augmentation can recapture the natural contour of your gums and jaw after the loss of a tooth as a result of trauma, congenital anomalies, infection, or periodontal disease. Achieving an ideal amount of gum and bone as a support to surrounding restorations or implants may require hard and soft tissue reconstruction. After the loss of one or more teeth, your gums and jawbone may become indented where the tooth or teeth used to be. This occurs because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indentation unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth, and this can create an area that is difficult to keep clean.
Ridge augmentation uses bone and tissue-grafting procedures to fill in the indented area of the jaw and gums, leaving you with a smooth gum line that coexists with your restoration or dental implant.
When you come to our office for your grafting procedure, a local anesthetic will be given to numb the areas involved. You may also receive medicine to help you relax. We want your experience in our office to be as comfortable as possible, so let us know if there is anything you need during your procedure.
Depending on your specific needs, the oral surgeon will perform one of three different types of gum tissue grafts.
Many factors will contribute to your chosen grafting technique. Your oral surgeon can tell you which method will work best for you, your health, and your smile.
- Connective tissue grafts – The most common method to treat root exposure, connective tissue grafting involves your oral surgeon cutting a flap of skin on the roof of your mouth (or palate) and removing tissue from under the flap, called sub-epithelial connective tissue. This tissue is then stitched to the gum tissue surrounding the exposed root. After the connective tissue, or graft, has been removed from under the flap, the flap is then stitched back down.
- Free gingival grafts – Similar to a connective tissue grafting, a free gingival graft involves the use of tissue from the roof of the mouth. But instead of making a flap and removing tissue under the top layer of flesh, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This method is used most often in people who have thin gums to begin with and need additional tissue to enlarge the gums.
- Pedicle grafts – In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap, called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sewn into place. This procedure can only be done if you have plenty of gum tissue near the tooth.