Why Do Some Dental Implants Need Bone Grafting Beforehand?

Dental bone grafting can be a preparatory surgery to prepare your jaw for a dental implant. But why must it be performed, and what does it involve?

The Longer You've Been Missing Your Tooth

If the tooth to be replaced with an implant is still in its socket and will be extracted immediately prior to your implant surgery, then grafting is unlikely to be a requirement. Not all patients require bone grafting before they can receive an implant, but it becomes more likely the longer you've been missing your tooth. 

Reversal of Bone Resorption

Bone grafting is decided on a case-by-case basis and may be necessary to reverse natural bone resorption. Your dental sockets are contained within your alveolar bone — a particularly dense part of your jaw. The loss of a tooth, whether due to decay or trauma, initiates the production of osteoclasts. These are bone cells that break down bone matter.

Synthesizing Bone Cells

The reduction of bone matter won't continue indefinitely. It's simply that the site of the empty dental socket no longer receives physical stimulation from the tooth. This stimulation maintained the production of osteoblasts — cells that synthesize new bone cells, keeping your jaw dense enough to support the tooth within the dental socket in question. This bone remodeling is an ongoing process throughout your body, but can slow down in your jaw when a tooth is missing — it's essentially your body conserving resources.

Loss of Bone Mass

As mentioned, bone resorption doesn't continue endlessly. It's most pronounced in its early stages, with about 30% of the alveolar bone's width lost in the first 12 weeks following tooth loss, continuing to about 50% within the first 12 months. Bone grafting restores this bone mass to prepare your jaw for its dental implant.

Hard Tissue and Integration

The implant is a small titanium screw that becomes a false tooth root, eventually holding a realistic porcelain tooth. Without adequate bone mass, there's not enough hard tissue for the implant to integrate with your jaw, hence the need for bone grafting in some patients. 

Types of Grafting

Bone grafting can be an autograft (bone tissue harvested from your own body) or an allograft (tissue from a donor). Nowadays, a synthetic alloplastic graft is common, utilizing a compound made largely of hydroxylapatite — which is a mineral found in human bones. Grafting requires its own surgical procedure carried out under local anesthetic. The grafting compound is applied and integration occurs as part of the natural healing process.

To last a lifetime, a dental implant must have a secure foundation — and sometimes grafting is needed to build that foundation. If you have any questions about dental bone grafting, reach out to a dentist in your area.