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Bone Grafting, Jaw

Bone that is not providing its normal function has a tendency to shrink, or "resorb." For example, if you have been missing a tooth for some time, you are very likely to have experienced some bone loss in the area where the tooth once stood. Similarly, severe periodontal (gum) disease is often associated with resorption of the surrounding bone. Bone grafting, aims both to replace missing bone and to stimulate new bone growth.

The technique has become routine in oral and dental surgery, and is used most frequently to prepare the jaw bone for dental implants. Dental implants sit on metal posts that are inserted directly into the bone of the jaw, and therefore, resorbed bone must be built up before implants can be placed.

Bone grafting can also be used for a number of other reasons, such as building up the alveolar bone to provide better support for dentures, or correcting bone defects caused by the removal of cysts, tooth extraction, or gum disease. More extensive bone grafts can also play an important part in reconstructive surgery for severe trauma, disfiguring diseases such as cancer, or congenital conditions such as cleft palate.

Treatment

Bone grafting is best done using the patient's own bone - this is called an autograft or an autogenous graft. Bone can be taken from other regions in the mouth, for example behind the molars, the chin, or the back of the upper jaw. For larger grafts, the most common donor area is the hip. Bone grafts taken from animals or cadavers are also sometimes used. In addition, a synthetic material has been developed that has properties similar to natural bone and can be used for small grafting procedures.

Bone grafting surgery is usually an out-patient procedure. During the surgery, the soft tissue is lifted to expose the bone, and the bone grafting material, either natural or synthetic, is placed at the site. Sometimes, a special protein is added which stimulates bone generation. The surrounding soft tissue is then sutured back into place.

Patients experience some soreness, swelling, or light bleeding after the surgery. Applying ice, or taking oral pain medications, should be sufficient to relieve any discomfort. Patients will need to take extra care in keeping the mouth clean after the surgery, as instructed by their surgeon.

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