Bone Grafting & Guided Bone Regeneration

Advances in medicine and dentistry have led to new and expanded areas of treatment including bone grafting and guided bone regeneration (GBR) in the jawbone and around teeth.

Procedures to repair and grow new bone are now fairly common procedures in dentistry. Below we have provided some information to help you better understand what bone grafting and GBR are, what options are available to you and what benefits you may gain from these procedures.

What are bone grafting & GBR?

Bone grafting is a surgical procedure that replaces missing bone with a bone graft material. This material not only replaces missing bone, but also helps your body regenerate lost bone.

The growth of new bone helps strengthen the grafted area by forming a bridge between your existing bone and the graft. Over time the newly formed bone will replace much of the grafted material. GBR is a procedure in which a membrane is placed over the bone graft site. This membrane encourages the growth of new bone and also prevents the growth of scar tissue into the grafted area.

When are bone grafts & GBR necessary?

Bone grafts and GBR will be recommended when a part of your jaw is missing bone. Examples include:

- Defects surrounding roots of teeth (periodontal defects)
- Defects which occur following tooth extraction
- Decrease in quantity of jaw bone from trauma or long-term tooth loss - Defects surrounding dental implants

Are bone grafting & GBR painful procedures?

These procedures are usually performed under a local anaesthetic or local anaesthetic with I.V. sedation.
Following the procedure, there will be some swelling and some mild to moderate discomfort. Your dentist will prescribe an oral analgesic to help relieve any discomfort.

What special care is required after my grafting procedure?

Generally, the same prudent care required after any dental surgical procedure will be sufficient. The area must be kept clean, often with the help of a prescribed mouth rinse. An antibiotic may also be prescribed but not always required.

We recommend you avoid any undue pressure over the grafted area until the new bone is well on its way to being formed. This will mean that any previous dental prostheses such as a removable complete or partial denture must be altered following the grafting procedure. And finally, good oral hygiene must be maintained, brushing and flossing your teeth regularly. However, avoid the gum tissues surrounding the bone graft until they are well healed (usually about six weeks).

How successful are bone grafting & GBR?

Advances in technology have dramatically increased the success of these procedures. Different graft and GBR materials can affect the amount of new bone formed. And, your own overall health will also help determine the degree to which new bone will form within the grafted site. Your dentist will discuss the procedure with you thoroughly so that you have all the information before undertaking the procedure.

Are there different types of bone grafts & GBR membranes?

Some grafts are taken from different parts of the patient's own body, typically the hipbone or chin. Graft material may also come from human organ donors, from synthetic materials, and highly purified bone mineral.

There are also different types of GBR membranes. Some are made from synthetic polymers and must be removed during a second surgical procedure several weeks or months later. Others are made from natural materials and are gradually resorbed by the body.

Which type of graft materials is used at your practices?

We use Bio-Oss, which is a safe, effectual bone grafting material derived from specially processed bovine sources. Under a microscope Bio-Oss is very similar to human bone and because of this similarity it’s very successful in helping new bone to form. Using Bio-Oss can eliminate the need for additional surgery to obtain the patients bone as grafting material in many cases.

How does Bio-Oss work?

Because Bio-Oss is so similar to human bone, it is accepted by our defence mechanisms as a "friendly" graft and acts as a structure onto which bone forming cells, blood vessels, etc. can migrate. As cells and blood vessels travel along the Bio-Oss structure, healthy new bone is formed and the original bone defect is repaired.

Is Bio-Oss safe?

Bio-Oss is completely safe. Since it is highly purified bone, no allergic reactions or infections have been observed following its use. Every batch of Bio-Oss goes through highly controlled processing and sterilization procedures, which remove all impurities. At the end of these procedures, every batch of Bio-Oss must pass rigorous tests for purity and sterility, assuring the total safety of materials.

How long does it take for new bone to form around the Bio-Oss graft?

Bio-Oss, because of its similarity to human bone, is highly successful in supporting new bone growth. Although new bone will begin to form within the first few weeks after grafting, several months are required to achieve the quantity and density of bone needed for further dental procedures to be performed.

What types of GBR membranes are used at your practices?

We use Bio-Gide, which is a thin resorbable GBR membrane made from the natural fibre material, collagen. Often when a bone graft is needed, Bio-Gide is placed directly over the grafted material. Bio-Gide encourages new bone to form and prevents the growth of scar tissue.

How is Bio-Gide different from other membranes?

Bio-Gide is resorbable, which means it melts away. Unlike membranes that do not resorb, it does not require a second surgical procedure to be removed. And, unlike most other “resorbable” membranes, which tend to resorb within 4-8 weeks, Bio-Gide lasts at least 4 months, the time required for new bone to form.

Finally, during the healing process, if an opening occurs in the gum tissue covering Bio-Gide, the opening will tend to close spontaneously, allowing bone growth to continue. Removal of the Bio-Gide membrane is almost never required.

Is Bio-Gide safe?

Bio-Gide, like many artificial membranes, is composed of porcine delivered collagen. Using special processing and sterilisation procedures, Bio-Gide is made completely biocompatible and sterile. Every batch of Bio-Gide membranes undergoes a series of tests confirming its purity and sterility, assuring total safety of the materials. Bio-Gide is not indicated for patients with a known history or allergic response to collagen or porcine derived products.

If you would like more information on bone grafting and GBR and are considering dental implants to replace missing teeth, call us on 0115 981 6986 or book a consultation and find out whether you are suitable for implant treatment.