Bone Grafting For Dental Implants…Where Do You Get the Bone?

When you lose a tooth, you lose bone with it.

Rebuilding the bone for dental implants is very common.  Unfortunately, there is not a lot of information made available to patients about where the bone comes from.

In this video, I will describe bone material options such as human, cow (bovine), your own bone and synthetic.

Questions?

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Burbank, California
https://www.burbankdentalimplants.com

18 thoughts on “Bone Grafting For Dental Implants…Where Do You Get the Bone?”

  1. Hi Dr . Amin , on the 18 of September this year I had all my 7 remaining upper teeth removed and placed 5 implants ,with bone graft (synthetic) and sinus lift. I was prescribed antibiotics before and after the procedure( clindamycin and metronidazole). There was a bridge put on my implants the second day after the procedure .Everything seems like is healing ok….as I was very very bruised and swollen after the surgery . My question is was the synthetic material good for my bone graft? and why now almost 2 weeks after the procedure the shape of my face looks kind of different , essp. the shape of my mouth and why I still have this feeling of fullness and swollen still around my nose. No pain . I still look little like a chipmunk.

    Reply
    • it sounds like you had a difficult surgery and hopefully was not treated by an inexperienced provider. Bruising and swelling are normal. Some people will even have some residual numbness. Because this is the upper jaw most of the time that numbness will go away. The feeling of fullness in your appearance should stabilize by week 4. After that you may need to make some modifications of the temporary bridge in order to manage lip support for a full arch restoration. I hope to heal up well and have a great result!

      Reply
  2. HELLO IM A DENTAL STUDENT HERE IN PHILLIPINES, MY INSTRUCTOR GIVE ME AN ASSIGNMENT, ON HOW YOU WILL PLACE THE BONE FOR BONE GRAFT…what the specific structure of bone will put.
    please help me doc! on how to explain to him cuz i need to defend it nextweek thanks in advance sir Ramsey

    Reply
  3. Hello wonderful Dr Amin!

    Is what you mention as ‘bone widening/expansion’ suitable for a front tooth? An area that still has the tooth and has a large area of infection/failed apico? Or is block bone better for that?

    I would like it to look as nice as possible, be strong bone and remain for many years as I’m in my 30s! Not sure if bone grafting does stay for many years or until I’m 70 at least? Hope so!

    Thankyou ?

    Reply
    • both techniques and work in this area but sometimes bone expansion may lead to a tooth that ends up being slightly longer at the gumline specifically in the upper front teeth. This is going to depend on the shape of your bone in cross-section which can only be determined by 3-D scan. Your surgeon will have recommendations for you based on what they feel comfortable performing. Many dental implants surgeons do not perform block grafts or bone expansion.

      Reply
  4. Hi I just got tooth number20 extracted today due to a failed root canel that was done 6 years should. The oral surgeon said there was bone loss did a bone graph and sutured me up he said not everyone is a candidate for an implant. I have to go back 10 weeks to evaluate and see how I do.
    What would happen that would result in the bone graft not working to get the implant.i was told by my original dentist I would be a candidate as I don’t smoke. Thank you

    Reply
    • Hello Jill,

      If the adjacent teeth #19 and #21 are healthy, it is very unlikely that you would not be able to have an implant for tooth #20. 10 weeks is probably a little bit too early to evaluate a bone graft. I would wait approximately 12-20 weeks and have a 3-D scan done and virtual implant placement.

      In my own practice, a socket bone graft is an extremely successful and predictable procedure. It is often modified with your own blood products and growth factors such as PRF. You should experience almost 0 pain.

      PRF

      Socket Bone Grafting….Do I Need It for My Dental Implant? Ramsey Amin DDS Reviews

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  5. Hey Doctor,

    I had consulted you earlier too with respect to myself getting an implant done for my upper frontal incisors. The corresponding link is given for your reference.

    https://www.burbankdentalimplants.com/disadvantages-of-dental-implants-the-cons/#comment-8203

    Off late, I’ve got the implant placed in the jaw last month after undergoing the orthodontic treatment for proper spacing, etc. for 5 months. Also, due to lack of amount of bone in the area around 1 tooth, an additional bone grafting was also done. But, unfortunately, there had been a slight drift in the implant position (initially placed parallel to the other teeth) observed in the O.P.G. taken the next day. The implantologist was quite unsure about the consequences of that and suggested I needn’t worry as the success of the implant would be only determined after the bone graft (Xeno-graft) takes up well after a period of about six months. I would just like you to advise me on the same and what possibly could be done.

    Thanks!

    Best Regards,
    Prakhar Jain

    Reply
    • Thank you for referencing the previous comments. It helped give me background.

      It is critically important for the front center teeth dental implants to be placed in an extremely precise position. Any degree of variation from near-perfect, will result oftentimes in a poor aesthetic result. There is very little wiggle room for error in this area of the mouth.

      Sometimes very soft bone allows the implant to drift during the final placement off of Center. This can often be prevented by the use of a computer generated surgical guide and or a highly experienced dental implant surgeon.

      In general the OPG panoramic x-ray is not a great x-ray for evaluating the position of front teeth dental implants. There is a lot of distortion in that type of an x-ray. Atypical, intraoral x-ray we call a periapical x-ray is better but this still only told you the two-dimensional placement. Do not always believe what you see on x-ray…. It is ultimately the real position in your mouth which is going to dictate the final result being what you desire.

      Nothing can be done except for to wait for bone healing to take place or to remove and replace the implant before integrates.

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  6. Thank you for your time doc…you are really awesome! I am moving to Cali in 6 months and I will come see you…i need a graft!

    Reply
  7. Hi Cheryl,
    What you are describing would be the most perfect material in the world! A synthetic material that can do all that you describe is not in existance yet.
    As for the second question, it sounds like you are describing connecting implants to natural teeth.
    Connecting implants to natural teeth is not recommended. Implants and teeth move slightly and they move differently. Often times, the tooth they are connected to is lost from decay due to this movement over time.
    It is a last resort.
    Ramsey A. Amin, D.D.S., D.A.B.O.I.
    Diplomate of the American Board of Oral Implantology /Implant Dentistry
    Fellow-American Academy of Implant Dentistry

    Reply
  8. Is there any synthetic material that now builds up bone without having to use bovine or cadeaver or a persons own bone that could increase height and/or width that won’t cause the material to shrink or collapse over time so the implant will stay?
    Also, is there a way to replace a bridge that already exists by removing the bridge that is attached to the far lower back tooth that has to be removed and is attached to the side teeth thus creates a bridge for 2 teeth in the middle that are missing? Can an implant hold up a bridge this way? ex. implant where back tooth would be; space( bridge ), space( bridge ), and then bridge over 2 side teeth.

    Reply
  9. Hi Cheryl,
    Let your implant dentist guide you here as each bone graft is so unique.
    I use all types of bone from your own, human donor bone bone, cow bone or synthetics. I have done so for 10 years.
    More important than the type of bone used is that it is the right type for YOUR situation. Surgical technique of your dentist is critical to the result.

    Reply
  10. What material do you use to fill up the socket on a lower back tooth extraction?
    If the lower side teeth are missing and you need to build height what type of material do you use to grow bone?
    I read the discussion about bmp, prp, etc. already.
    I need to have my lower back tooth removed and then since I am missing the 2 teeth next to that which a bridge is over my 2 side teeth connected to that back tooth I am looking for opinions on what is the best and safest and non allergenic materials to use for this.
    I am in florida….wish I was in CA. and am looking for wise opinions.
    Thank you!

    Reply

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