Bone Graft: What is it? Pros & Cons + Different Types
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- Опубликовано: 1 авг 2024
- If you're having oral surgery done, chances are you've heard of a “bone graft". Bone grafting is commonly used after removing teeth or when placing dental implants. But what exactly is a bone graft? Dr. J explains everything you need to know about bone grafting to help you understand what it is that your dentist is placing inside your mouth:
2:10 - What is a bone graft?
6:10 - Bone graft procedure
8:53 - Types of bone graft
13:06 - Advantages & disadvantages
18:24 - Cost
21:36 - Dr. J's final thought on bone graft
Looking for a new dentist who does bone grafting? Start your search for a great dentist on Even28, the dentist search engine: www.even28.com
Thank you for this video. I went to my dentist after losing a crown and he referred me to an oral surgeon to have the tooth removed. Neither dentist explained much about the bone graft except that I needed it done. I asked a lot of questions but still did not feel that I understood the procedure or why I should have it done. After watching this video I now feel more informed and comfortable with having the procedure done.
Hi Jane. Glad you found the information useful. You know, if dentists and oral surgeons were to actually explain everything that they do, they would be out of business... It just takes too long. I guess that's why we use informed consent forms. Of course let's be honest, most people don't read these forms and simply initial/sign them. I am always shocked when I walk back into a room after 10 minutes and the patient is still reading his or her consent forms. By this time most patients are on their cellphone! Best of luck with your treatment.
@@johnjazayeri yeh that's true.cellphones are really making things difficult now😅... well my surgeon also explained me everything before surgery....i did my surgery in a dental college in pune,india .... where students of post graduation perform surgery afcourse under experts supervision .....but the dose of antibiotics was high ....becoz of that next day after surgery I started vomiting...which made things scary for me .
Well keep making content.best of luck to you 👍😃
Agreed same situation here😢 Had it done after extraction and healing now
I had the same experience... thank for this very eadu to understand explanation 👏
I thought this video was too long but everything you talked about was so substantial that I didn't expect the video to end already when it did. Thank you so much for the information. I wish there are more dentists like you but I understand not all dentists are oral surgeons as well. In my country majority of the dentists here don't even discuss or suggest getting a bone graft after the patient gets an extraction. Only very few dentists think futuristically and make suggestions for the long-term benefit of their patients' oral health.
Dr John Willerdsen TRUST Implants Newport Beach Did my Full Mouth Reconstruction
I Highly recommend him
GET a consultation no cost You'll see.
Thank you Dr. Jazayeri for taking the time to explain the bone graft process thoroughly. I am not scared about the procedure anymore🙏🏼😊
this video took out the mystery of a procedure which is part of my treatment plan. Thanks!
Doc I appreciate this video. Thank you
Thank you for this, i was getting nervous not sure what to expect but you explained it clearly and now i don't feel so nervous.
Go to Antalya Turkey. Fraction of the cost and dentists are awesome.
Thanks Dr John for your simple education on the subject. I believe you will be a very good doctor just as your educational skills.😊
Great video and very informative..Thanks
Great information Thank you
Thank you for the time greatly appreciated sir
Thanks for info doctor
Thank you doctor.
Thank you for taking out the mystery of dental bone grafts. I feel confident at the prospect of having one in a few weeks. This is very helpful.
How did it go? I’m needing a bone graft in a few weeks time, I don’t really want it as I’m not getting an implant, but the oral surgeon seems insistent.
@@antoinettefrancis5036 Got referred to an oral surgeon for a broken tooth extraction. Back to the dentist after healing period to finish the work for a 'flipper' partial, replacing 3 teeth. I'm a senior & no bone graft was necessary.
This was great! Great delivery! All the best! Thank you!
I went to Mexico and had my bone graft and extraction done I had great care and the facility was state of the art. It cost me a total of $1700 a little less than $1700, 1600 and some change and that included stem cells bone graft two extractions antibiotics, anesthesia pain, medication, and a temporary partial. I could not afford to get it done in state, and I am so grateful I had the courage to think outside of the box. Mexico is awesome and the country is amazing and the people are kind that even included a personal driver. I just had this done three weeks ago. I am three weeks into the healing process. I have to go back in about six months to a year to get my permanent partial done. I’m very happy that they did the bone graph.
Hi Ms Pepper. Glad to hear about your good experience. A good dentist is a good dentist, no matter where you are. Frankly, American dentists can't compete on pricing with dentists outside of the U.S. due to their steep overhead. Best of luck to you!
Thank you❤. My dentist extracted my tooth and never did a bone graft. He said I would need it when doing an implant. If I had viewed your video sooner, I would have told him I wanted a bone graft at the time of extraction. I think I will find another dentist. 😊
Thanks a lot!!!
Thank you sir. I like your videos very much
I just did my tooth pull and the bone graft yesterday. I'm glad i did it all at once
Oh my God so I need a more advanced bone graft now! I had 2 tooth pulled about 10 years ago 😩😭
Don’t panic they can fix it.
Great great vic doctor love it so simple I understand please keep posting. Can you explain the consequences of bone loss a d gum loss please
Bone loss causes looser dentures, poorer prognosis for implants, and increased likelihood of jaw fractuce. Gum loss also affects denture fit and has dire consquences.
👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍 for this dental video
Hi, can you please tell me your thoughts on locator fixed implants. This is what my dentist used for fixed implants
Your awesome
Thank you for a simple, informative, and thorough video. I just had a bone graft done after a molar extraction where a failed root canal was performed three years ago, and bacteria was around the molar🥴. Why was my bone graft $1,793 in Santa Clara, CA? I go back for a follow up appt. in two weeks to check what?
Doc if you time could do v on consequences of bone and gum loss and how your face would change a family member got this problem thanks
Hi Kalpna,
Sure, I can make a video on this topic soon. In the meantime, here's a summary: When you lose a tooth or multiple teeth, you start to lose the supporting jawbone (at 3 times the normal rate!) You also lose most of the keratinized gum tissue that surrounds the teeth. This is the high-quality, firm gum tissue that you want to keep. See, when a tooth is removed, the body stops caring for that area. As a result, you lose lots of bone as well as the high-quality gum tissue in that region. The only way to avoid this is to either keep your tooth or replace the missing tooth with a dental implant. Dental implants work nearly the same as natural teeth do, in terms of bone and gum preservation. The body thinks the implant is a tooth, so it preserves the jawbone and gum tissue around it. Hope that helps answer your question.
Love this video,, where are you located maybe I can come see you can I get more information? I live in Florida so just wondering if I can see you for a bone extraction
Great info, thank you. I am going to get some implants in 2 weeks and I will have a bone graft. Procedure. My question is can they do the implant and bone graft at the same time 🤔 thank you for your time
Hi. Great question. I'm going to get technical here. You can do the bone graft and the implant at the same time under certain circumstances. However, the initial stability of the dental implants has to come from the patient's own jawbone NOT from the bone graft. This means that if you have a massive bony defect, you can not place the implant at the same time. If however, your dentist can secure the implant inside your jawbone, then there is nothing wrong with adding some bone graft to fill in the voids. I have an entire video that gets into all of that, a technique known as immediate dental implant placement, check it out if you want to learn more: ruclips.net/video/UtQ13pdST9U/видео.html
Hi doc I’ve had three took bone from hip. Now they want take fibula from my leg cause last one I had infection been struggle
Thank you doctor ❤ God, Angels and the Universe bless you ❤ you have made alot of us feel better ❤ I had my upper molar tooth extraction and bone grafting done yesterday (after my doctor convinced me) but I have been very stressed until I found your video I feel less stress now. Once again thank you very much for your thorough explanation. Even you didn't work on our teeth but you actually save our mind helping us to have more faith on the path to recovery ❤ God bless you ❤❤❤
Great video......you put my mind at ease! Just one question. I need to have two molars extracted, and will need bone graft. Can I manage pain with ibuprofen, and a prescription pain killer? Thanks.
Hi Marco. Ibuprofen is great as it's an NSAID. It helps reduce pain as well as inflammation. If the surgery is more difficult, I would request a prescription painkiller as well. For best results, take both, the Ibuprofen and the strong narcotic, together. Good luck with your extractions!
@@johnjazayeri Thank you very kindly for responding!!!✌
Im allergic to nsaids. Dentist aka brute butcher yanked me a 3rd molar, i was having neck + tmj pain 4 many days after the secretary said "just take paracetamol!".... what shohld i say, should i EVER need another extraction...?
@@NikkieRoxxxI'm allergic too and I just followed Dr instructions and took paracetamol 1mg the first day, the second day didn't happened anything, because I was being careful of what I eat, cleaning with the liquid he gave me buuut I was dizzy, today is the 3rd day no inflamations no pain but dizzines as hell, walking slow, so I'm trying to no make efforts for five days. He told me to stop the antibiotics for the dizzines. There is also a gel to sleep your gum u should ask your Dr if u can use it, benzocaine. Yes we the allergics gotta wait on pain, better than get an allergy.
Full top teeth extraction. Is it a smart idea to get a two post bridge type implant of my front 4 teeth with a partial denture for my other teeth? Don’t want only dentures on top my entire life but a full mouth of implants is very expensive
Hi there. Great question! Your idea sounds great on paper: Why not put a 4-unit bridge on top of two dental implants to at least have a smile, and then fill the gaps with a partial denture? In reality, there are a few issues with this idea. First off, if you only have two dental implants, your entire chewing forces will be applied to these two implant screws. This is too much stress. The implants will most likely fail within a few years, or the bridge will crack in half. This idea only works if you have a lower denture, and not natural teeth on the bottom. The other issue is the incompatibility of partial dentures and implant crowns. It's never a good idea to combine implant crowns and bridges with a partial denture because it just doesn't work too well. You'll probably end up not wearing the partial denture. Let me propose two alternative treatments, which may be more affordable than full mouth dental implants and all-on-4 teeth:
1. Snap on dentures with 4 implants: Get a full denture, be sure to place a wire inside for reinforcement, and place a few dental implants to stabilize the snap-on-denture. I recommend 4 dental implants if you have a full set of natural lower teeth.
2. 8-unit bridge on top of 4 implants: Have your dentist place two implants on the left side and two implants on the right side and then make an 8-unit bridge on top of these 4 dental implants. Obviously, this is more expensive than placing 4 teeth on top of 2 dental implants. However, keep in mind that you need a minimum of 4 dental implants to support permanent teeth long-term. This option is much simpler than full mouth and all-on-4, the only difference being you don't get molar teeth in the back. Unfortunately, this option isn't that cheap either, but it does cost less than all on 4 teeth or full mouth implants and it's a more simple treatment which more dentists can perform.
Hope that helps a bit. Feel free to send me your X-rays for a second opinion. You can post them here, or you can send them to TPMyMouth@gmail.com. Good luck!
How do i find your other videos?
Hi Doc,
Question: I had a bone graft procedure done 3 days ago. They added a paper covering and stitched the gum. However, the paper has come loose and is hanging out. I can feel the socket and try to stuff the paper back with my tongue. When eating, I eat on the other side. It tend to come off either way. Is this normal during the healing process? I went back yesterday to get it checked out and I feel like my dentist stuffed the paper/stitches back in.
Does getting a bone graft painful after the surgery is done?
Very Informative... Thanks so much.🌷 ? Is a bone graft (4 on top, 4 on bottom) required for traditional dentures,only? No implants or snap ons. Thank you.
Hi Gee. Glad you learned something! Bone graft does help preserve jawbone, so it can be helpful for dentures. However, that's more so the case when you are removing a whole bunch of teeth. If you only need 4 top and 4 bottom teeth removed, doing the bone graft won't have much of an impact. In contrast, patients who are removing 10-12 upper and lower teeth, should really consider getting a bone graft. Having thicker jawbone makes it easier to wear dentures, even in the absence of teeth. Good luck with your treatment.
@@johnjazayeri Thank You for your reply. Do wish you were closer to San Fernando Valley, area. Happy Wednesday 🌹🌹🌹
I wish you were my dentist. you are very entertaining.
this was very helpfull. also, I have a question. I have periodontitus (it only affected my front teeth up and down) would I still be a good candidate ??
Hi Ariane. Glad that you learned something. Periodontitis, or gum disease that affects the jawbone, is not treated with bone grafting directly. In other words, you can't just sprinkle some bone powder around teeth and expect the bone to grow back. The bone loss around teeth is irreversible. All you can do is contain them so they don't get worse. And considering that these are your front teeth, I highly encourage you to take it seriously!
Treatment for periodontitis depends on the stage of gum disease. If it's early, you need deep cleaning. Be sure to go every few months for follow up cleanings afterward. For more advanced periodontitis, you may require gum surgery. Gum surgery actually requires removal of bone and gum tissue to allow the patient to better clean his or her teeth. However, you can't just add bone to teeth with bone loss. Hope that helps and good luck with your smile!
@@johnjazayeri hi again. I wasnt implying to just sprinkle bones around my theet. I figure that I'm gona loose them. what I was wondering ( cause Ive seen you do some miracle with a mans front bottom. ) is if it would be possible to take my teeth out, THEN bone graph the area an Then put an 2 or 4 teeth bridge
implant. Is this something that could make sense?
Hi again Ariane. The decision to remove or keep your teeth, especially the front ones, is an important one. There are so many factors that come into consideration here. Obviously, the most important one is the prognosis of these teeth. Do your teeth have a good chance of lasting another 10 years? Factors such as your oral hygiene, smoking, diabetes, etc. also come into play here. If your teeth are worth saving, then absolutely save them! Improve your oral hygiene (brush + floss + waterpik), increase your cleaning frequency, etc. If however, your teeth have poor prognosis, then there's no point of putting more time and money into saving them. Go ahead and remove them and replace them with dental implants as you had planned. It all comes down to the prognosis of your affected teeth.
Interested in a complimentary 2nd opinion? Feel free to shoot me an email of your recent X-rays. You can reach me at TPMyMouth@gmail.com. Tell me a bit more about yourself, like your age, smoking habits, relevant medical issues, etc. and I'd be more than glad to share my thoughts with you. Best of luck!
Very honest and thorough. Thank you.
I had my front tooth implant this week and while I was under anesthesia, she said she added more bone and the autograft adding another $1000 to plan of $6000. She did not draw the blood when she started the iv as was done 6 months prior when I had the extraction and bone graft. I questioned this since in the medical field, we never draw blood from an iv running only on initial stick.
She said my ct looked "great" 11 days before my implant and was ready. My question is, how common is adding more bone a second time once a pt is under and is it common to draw blood from an iv line in dentistry? I would appreciate an answer.
Hi Karen. Sorry to hear about the skyrocketing cost of your treatment! You are correct, there was most likely no blood drawn during your implant treatment. To clarify for other readers, I'm guessing you had a bone graft, extraction done earlier where they drew blood, using a centrifuge, to create PRP (Plaetlet-Rich Fibrin). The PRP technique helps improve healing so you generate more bone and gum tissue growth in the extraction site. Back to your question, they most likely did not draw blood during IV treatment. However, that doesn't mean your dentist did not add more bone graft. They could have added synthetic or animal-sourced bone during the surgery. Keep in mind, the bone graft added during implant placement does NOT contribute to the implant stability (it's just powder afterall). So the only purpose of such a graft would be to fill in voids in the bone surrounding or neighboring the implant. Now, did your dentist really do that? And should it have cost $1,000? I don't know, I will stay out of this one! But I gave you all the info you need to discuss the additional treatment with your dentist. Either way best of luck with your dental implant!
Doctor Jazayeri, I am having a lower jaw premolar extracted, the one just before the large molar on the right side. Also, I'm a 48-year-old male with no history of gum or bone disease in my mouth and I am still in good health. In any case, my dentist said he will put in a cadaver bone graft right after the extraction. Now, dentists always talk about teeth shifting if you don't get an implant. But from my experience I've only seen teeth shift in people who had bone loss due to gum disease, infection, severe trauma, osteoporosis, or have undergone orthodontic treatment. The tooth they are going to remove in my mouth was fractured beyond repair but there is no infection. Also, this tooth has never fit correctly in my mouth and has always been problematic when eating on that side of my mouth, but the rest of my teeth are fine. I have a STRONG feeling that once this tooth is removed my teeth will fit together A LOT BETTER. So, I have several questions. If I have no trouble eating on that side of my mouth after the extraction, can I just skip the implant OR will my teeth possibly shift even though I also got the cadaver bone graft? Also, how long does the newly regenerated bone from the graft last without the implant? Meaning, how long can I wait to get an implant if I want one in the future? Thank you.
Hi Chris. Thanks for your questions. Let me answer them one at a time:
#1: If I have no trouble eating on that side of my mouth after the extraction, can I just skip the implant OR will my teeth possibly shift even though I also got the cadaver bone graft?
Dental implants are great, but they aren't mandatory. A bone graft does nothing to stop teeth from shifting. Teeth WILL shift if there is a gap next to them. So the tooth in front, the one behind, and the one above, they can all shift over time. Of course this takes years, more like decades, and it does not happen over a few weeks or months. If you're 18 years olds, then yeah, your whole bite will become screwed up as a result of losing a single tooth. At 48 years of age, the shifting will be minimal. It will happen, but not to the point that messes up your bite. So I wouldn't do the dental implant for the sole purpose of stopping your teeth from shifting. There are other benefits to a dental implant, like preserving jawbone, protecting neighboring teeth, balancing bite forces, reducing stress on neighboring teeth, etc. Those are the real reasons why it's best to get a dental implant. Plus, at 48, you may lose another tooth, or two. Then you are really at a handicap for chewing and at serious risk of teeth shifting. So it's always best to place a dental implant if you can afford it. But no, it's not like your teeth will shift all over the place if you don't replace a premolar at your age.
#2: how long does the newly regenerated bone from the graft last without the implant? Meaning, how long can I wait to get an implant if I want one in the future?
The bone graft settles down after a few months. Generally, you can place a dental implant some 3 to 6 months after the bone graft. If you don' place a dental implant, you may lose another millimeter of bone over the next ten to twenty years, but not enough to have any meaningful impact on your treatment. The success of the dental implant has a lot more to do with where the Inferior Alveolar nerve is positioned as opposed to how long you wait to receive your dental implant. Lower premolar teeth are very close to the nerve, an area we refer to as the mental foramen. If your nerve curves up here, the dental implant will be very difficult to do, even if you receive it 6 months after the tooth extraction. If the nerve sits low and far away, then you can place the dental implant now, 5 years from now, or 20 years from now, it won't make a difference. Sorry if I got too technical, but I hope this helps a little bit. Best of luck either way!
Great answers! Now, I have just one more question. I did go ahead with the bone graft, and it was cadaver bone. Also, the graft was placed ten days ago, and there is no longer any pain and no sign of infection, according to my dentist. My only complaint is that the graft site feels very tightly packed and full. I know these grafts are typically overfilled, so here is my question. When will this feeling of fullness go away? Thank you.
Very informative! But I don't think I heard him say how much time the bone graft needs to heal in terms of weeks or months before implants, bridges etc can be put in place. I would really like to know the answer to that question.
Hi Richard. Sorry for forgetting to mention that! Typically, bone grafts take anywhere from 2 to 9 months to heal. That is a large time gap because there are many factors which impact the grafting healing time:
1. Position of graft in the jaw (front region heals faster than back, lower jaw heals faster than upper jaw)
2. Medical history
3. Smoking history
4. Size of bony defect
5. Type of graft used
6. Patient compliance
I would say the vast majority of bone grafts are ready for a dental implant in about 3 to 6 months. If the defect is minor, you may be able to receive your implant in as little as two months (or even right away!) If the defect is massive, then 9 months or more are also possible. Your dentist or oral surgeon will give you an idea of how long you should wait before the next step.
@@johnjazayeri I wish you'll do a video on the stages of healing what it looks like 1st day 3rd day etc.
I'm looking at mine and wondering if its healing or is it infected. It's been 4 days.
@@johnjazayeri can you also do a video on do and don'ts for patients after bone graft surgery. What diet makes it heal well what not to eat etc. How to prevent the area from being infected.
He's like the Quentin Tarantino of dentistry in how he enunciates and talks.
He's persian, not italian 😂
What is a graft that has liquid or gel squirted int to he socket when an all on 4 is done?
I know someone that had this type.
I believe what you're referring to is Platelet-Rich Fibrin, or PRF for short. This is a procedure where your dentist pulls your blood (from an artery, not your mouth!), centrifuges the blood, and uses the PRF layer to enhance healing. I typically use PRF for extensive bone grafting procedures, where there is not enough jawbone for the graft alone to work. I also sometimes use PRF for complex sinus surgeries, particularly lateral wall sinus graft. Some dentists use PRF on every single dental implant. I don't feel that it is necessary, but I do recommend PRF for more extensive treatments involving multiple teeth, etc.
Question , When getting a bone graft same day as extraction will I see a negative difference in facial structure or sinking stil??
Placing a bone graft helps improve bone growth in tooth extraction sites. However, it's not like you won't have any bone growth without the bone graft. The bone graft helps encourage more bone growth. The difference is typically a few millimeters. So not a whole not, certainly not enough to be visible to the naked eye. However, when we're talking about dental implants, a few millimeters makes a big difference. You also lose bone over the years. So if a tooth is removed and you place a bone graft, you'll have the most amount of bone possible. If you don't place a bone graft, you'll have less bone. If you put the implant into the hole, you preserve the remaining bone. If you leave the gap empty, you continue to lose additional bone. 10, 15, 20 years later, you will have significantly less bone in a region where your tooth was removed and an implant was not placed. This is not an overnight process, but it does happen gradually over time. I hope this helped answer your question to an extent and good luck!
I would really like an answer to this, Why can't the pulled out tooth be preserved and ground into a powder if it's still a healthy tooth. and used, in the case of a broken tooth
Hi Annette. Glad you asked this question. What you explained is actually an option. You CAN remove the patient's tooth, grind it and use it as bone graft (assuming the tooth is not infected). The reason this is not commonly used is the time it takes to perform this task. Most dentists, including myself, find it easier to just buy approved graft material and use it for bone preservation. However, you can grind the tooth and use it as graft. Maybe this procedure will pickup more in the future. For now, 99% of times your dentist will use synthetic or animal sourced bone graft material, or collagen, to preserver your jawbone. Good luck with your extraction!
Hi I just went July 2nd he extracted an eye canine tooth in front under bridge. 2 to 3 days later I got dry socket. He packed it then 4 days later took it out less than week later developed dry socket again 😢. Now after packing it again, about a week later he took the packing out. Now they are talking bone graft under my 7tooth bridge. I heard it's not necessary, because I'm not getting implants. What do you think? Do I really need bone grafting? It's alot more money. Is he taking me for a ride?? Thanks
Do they have procedure to restore gums that have shrunk significantly?
Hi Angela. Great question! The answer is a bit trickier than you might think. Typically, when you lose gum tissue, you also lose the associated jawbone. If that is the case, then there isn't much the dentist can do for you. In other words, you can't regrow gum tissue if the jawbone has also shrunken. There are other cases where the gum recedes, but the jawbone is fully intact. There are treatments that can rectify these situations. Gum graft is one of them. Pinhole surgery is another option. You probably want to see a gum specialist, known as a periodontist, to seek treatment. Keep in mind, these treatments are very expensive. Therefore, it is really only worth it if you have multiple receding gums. For one or two teeth it's usually not worth it. I hope this helps. Best of luck!
Is it better just to remove the remaining teeth I have left on top which is 7 instead of them trying to save the tooth and get a root canal and crown when I just want top densures
Hi Sherry. Obviously, I would need more information to provide you with an accurate answer. Nevertheless, let me try to provide a general answer to your question. So you have 7 teeth left and are considering dentures. You have a few options:
1. Save all of the remaining teeth and make a partial denture (or add dental implants to fill in the gaps)
2. Remove the worse teeth, save the good ones, and use these teeth to anchor your partial denture
3. Remove all of your teeth and go for full dentures
Each option has its pros and cons. The first option is the most expensive. Now, is it worth spending thousands to save a few remaining teeth? Especially knowing that these teeth are on borrowed time since the partial denture is likely to cause you to lose them over the next decade? It's up to you. If you have the time and resources, it's not a bad option.
The second option is a more practical one for those who are interested in transitioning to partial dentures. I suggest that you save about 3 or 4 of your best teeth. Use these teeth to anchor your partial dentures and remove the rest. I prefer to save teeth that don't have or need root canals and crowns. I also prefer to save teeth in a fashion that they are spread through the mouth, like the molars and canines. This option costs less since you are not saving teeth that require a ton of work. Plus, you will still have a few anchor points to keep your partial denture in place.
The final option is suitable for those with terminal gum disease or teeth that are just not worth saving anymore. If you can save a few of your teeth for several more years then you should do it. The later you transition to full dentures, the better off you are. Partial dentures are much more stable than full dentures. Plus, you will have several years to get comfortable with wearing dentures before transitioning to full dentures.
I hope this provides some sort of guideline for you. Having said that, I really need to study your X-rays (feel free to attach them here), evaluate your oral hygiene, and take other factors into consideration when making this decision. For example, if you have medical conditions that exacerbate bone loss, I would gear more toward removing teeth as opposed to saving them. Your age is another factor. I would advise a 30-year-old to try to save all of their remaining teeth, whereas for senior patients I am more inclined to remove teeth and transition them to partials or full dentures (or dental implants if they can afford it). Good luck with your treatment, and let me know how it goes!
Excellent video and I’m getting an extraction tomorrow. My dentist briefly discussed a bone graft but I was hesitant to agree at the time, so he said that he will just extract the upper molar and let it heal. Now, however that I’m informed, I’ll ask him to do it tomorrow. It’s a ridiculous idea to do it at a later time. Thanks
Hi there. I know it sounds weird, but there are plenty of dentists out there who don't care to do a bone graft after removing teeth. It's particularly weird because almost every patient I have encountered is willing to pay for this procedure. So the bone graft benefits the patient (better healing, less complications, improved chance of receiving a dental implant, etc.), benefits the dentist (more money, better results, less complications, etc.) and yet many dentists still don't care to offer it to their patients. Why is that? Frankly, it's because these dentists don't do surgeries, and they don't care about dental implants. The previous generation of dentist would do anything to save a tooth. However, when the tooth was hopeless, the dentist also stopped caring. Dentists who do implants ALWAYS recommend bone grafts. I mean, spending a few hundred bucks now can really save lots of headaches down the line. You should always assume that the patient will get a dental implant, even if they can't (or don't want to) get one at the moment. So yeah, push for bone grafts, or go find another dentist who will do it for you! Good luck with your treatment.
@@johnjazayeri Thanks for the sage advice. Yes I spoke to my dentist and agreed to do the bone graft, however after the molar was extracted (upper, second from back) the damage from the ongoing infection was so destructive that I was told that I’d be wasting my money with the bone graft, since the hole was far too large.
This was concerning. He says I’ll need serious bone replacement surgery if I am to get the 4 on 4 dentures in future.
The background on this tooth is this: 3 years ago a large filling was done. The area around the filling became infected. Then a root canal followed by a second root canal after the infection refused to cease. (3 courses of antibiotics inbetween the root canals). Then was sent to an orthodontist who planned a 3rd root canal. While waiting for this, the infection was raging throughout my maxillary sinus and extremely painful. The molar then cracked in half and I had it removed 11 days ago. It’s healing fine now.
Does this sound ridiculous? Thanks for your wisdom and I enjoy your channel
@@big_red_machine3547 Wow. Hope you are feeling better now. You really went through a lot of trauma. GL.
@big_red_machine3547 wow, sorry you had to go through all of that. It makes you wonder when to let it go because if you had the tooth extracted earlier, you would not have had to go through all of that drama. It's so hard to know what to do, and so darn expensive.
@@darlenedrivera165 Totally agree
What are the risks or side effects of having a bone graft after extraction?
Could the bone graft (foreign object) interfere with the body’s natural bone regeneration?
Thank you.
Hi there. There really is no risks to getting a bone graft. If it's synthetic graft, it's 100% safe. If it's animal sourced, it has to be processed correctly from a bone bank. If so, again, there's almost no risk. You can ask your dentist for information about the source of your bone graft to obtain more information.
Hi, have you ever had a patient with hashimotos (autoimmune thyroid disease) get a cadaver bone graft and react to it or reject it? I need an infected root canal tooth (infection has damaged the bone) extracted, does the bone graft need to be fine immediately or can I wait a few months and see how the infection heals?
Hi there! I personally can not remember having any issues treating a patient with Hashimoto's disease. However, I have performed countless surgeries on patients with thyroid conditions, hypo and hyper, and it's never been a risk factor. I would get the bone graft at the time of tooth extraction as it produces the best results. Also, I would look into getting a Zirconia dental implant, as opposed to titanium, since they are less likely to react with the immune system. Hope this helps, and best of luck to you!
Do bone grafts still help I’d someone has had extractions done many years ago?
Hi Aloha. Bone grafting is always helpful. Once your tooth is removed, your bone continues to shrink over time. As time passes, you will have less and less jawbone. There are patients who come to me and they say "I had the tooth grafted" but their bone graft was done 10 years ago and now they need another graft. It depends on how well the initial surgery/bone grafting went and how much time has passed. It's not uncommon for me to have to do a second bone grafting just to restore the jawbone and be able to place a dental implant into the jaws.
Dr Jazayeri, I had extraction and bone graft but my recovery was painful. I had so much pain in the gum area. I went to the dentist, he checked and said he did not take out enough bone so he did another bone graft .
Please let me know what action should I take. I wish he recommended me to a specialist so the extraction could be done more professionally. It has been more than a month now, my gum still hurts. Can you give me some guide lines. Thank you.
Hi Connie. I'm so sorry to hear about your situation. Having severe pain after a tooth extraction can have several different causes. The most common one stems from the damage to the jawbone during the tooth removal process. Generally speaking, the more jawbone removed during surgery, the more pain you will experience afterwards. Sometimes the tooth roots break and this requires cutting jawbone to remove the broken root. This will almost always be painful afterwards. Going to a more experienced dentist or a good oral surgeon helps. But sometimes the reason is because the tooth roots are curved. Or maybe your jawbone is stiff. I have a 6'7" basketball coach who I've done several extractions and implants on. He has the stiffest jawbone. Every time I pull a tooth on him, I spend at least 30 minutes cutting his jawbone to remove the tooth fragments. Surprisingly, he never has any pain either. Anyways, I'm digressing. Removing excessive jawbone causes dry socket. That is probably what you have. Dry socket takes several weeks, sometimes a few months, to improve. There is no treatment (antibiotics don't help). Don't irritate the area and it should gradually heal over time. Sorry about your experience and best of luck. Are you planning on doing a dental implant?
I have a question about the procedure, do it return your facial structure back to normal after it began sinking in due to bone loss?
Hi Floyd. Bone graft by itself does not return your facial structure back to normal. You need actual permanent teeth to push your facial muscles back to their original position. In other words, you need the bone graft plus the implants to restore your facial muscles. Keep in mind that the wrinkles which you've already developed will not go away, however, you will stop developing more wrinkles in the future. Hope that helps answer your question.
@@johnjazayeri I haven't developed any wrinkles, half of my face with the missing upper tooth developed a sunken in appearance and I was just wondering if that's reversible, I'm pleased to know that it is. Hopefully my dental implant journey is a big success
Can i still do bone graft after I lost my teeth for 40+years ago?😢
Can we add bome graft palatal of upper premolar?
Hi there. You can add bone graft anywhere you'd like. The upper premolar region has soft bone, so the graft will take longer to heal. Plus, there is the sinus membrane which sometimes interferes with implant placement. Still, there is no issues with placing a graft here, so long as there is not a tear into the sinus membrane or oral cutaneous fistula (OCF).
Hello Dr. John, why does bone grafting cost so much? $650 was the quote I got. Which is double the cost of an extraction by an oral surgeon! Why isn't it a standard of care that all dentists know, understand, educate and give patients the option for grafting to preserve the socket? I had an extraction last year by a general dentist who didn't know what he was doing and nearly broke my jaw. He never mentioned bone grafting and I had no idea it even existed so not sure if I'll run into issues when its time for an implant or not. But if there is, my question is even more relevant. Why isn't bone grafting education a standard of training in dental schools and standard of care in the practice of dental medicine? You mentioned the graft material is either synthetic or cadaver. Did you also say it can be obtained from your own jaw bone? How does that work? What kind of dentist does that and how much does that cost? Thanks kindly
There is a world of difference on how an iliac crest graft works compared with particulate grafts.Putting synthetic graft into a socket is counterproductive unless it is resorbable by osteoclasts.Such particulates are best used on buccal cortical plates and covered by membranes.Particulate grafts work more like osteoconductive They don't turn into bone themselves.Osteoclasts have to resorb the graft,followed by osteoblasts doing their job.Covering with membrane prevents wash away by blood and gives the physiological process of bone formation enough time.
100%. Thank you for explaining this so well. I do try to make things simple for the purposes of patients. But what you said is absolutely correct. Sticking a small piece of graft material into an extraction socket has little benefits. If you can place a suture to hold it in place, it'll be a bit more effective. However, most of the graft will be washed away and the effects are minimal. If you really want to generate substantial amounts of bone, you need animal sourced bone plus a permanent membrane. Having said that, most cases don't need as much jawbone. At the end of the day, any grafting is better than no grafting at all.
I've had dentures for 5 years and I wish I would have known all this and been told to have bone grafting. Is it to late for me to do this? I have had alot of bone loss.
It might still be possible. If you don't mind me asking how old are you?
I have big bone lost doctor extracted my 2 teeth. Do I still have bone graft option?
Hi there. Sorry about losing your two teeth. Don't worry, not getting a bone graft does not mean you have no bone left! Bone graft helps your body generate more jawbone. If you don't receive a graft, your jawbone still heals, but you will have less jawbone. If you decide to get dental implants in the future, this may pose a problem. Although there are other factors that come into play. But don't stress too much, you still have jawbone if in case you decide to go for dental implants. Best of luck!
I have a defect in my right mandible (under growth) and because of this under growth, the left mandible developed properly and there's a shift of the lower jaw to the right.
A Dr is suggesting of pairing down the projection on the right mandible without doing orthognatic surgery with bone grafting since the TMJ is functioning properly. My jaw bends to the right and am 50years. What is your advice. Am in Nigeria.
Hi Jude. Your case sounds rather complex and I really can't give you advise one way or another without getting more details. Why are you trying to fix this problem now at age 50? Usually orthodontic misalignments are treated in teenagers where the jaw is still developing and it's easier to correct the bite, or in adults who are suffering from some sort of complication (TMJ pain, etc.) If you don't have any complications, I suggest that you leave it alone.
Would you need a bone graft for a bottom wisdom tooth removal that isn’t coming in correctly because no room. Dentist recommended it, but I don’t see why if there will be no implant going in.
Hi there. This one is a bit controversial. Some dentists/oral surgeons don't care much for grafting after wisdom removal whereas others perform a graft every time they remove a wisdom tooth. Here are the pros and cons of bone grafting after wisdom teeth extraction:
Pros:
1. Better and faster healing: Especially when your dentist/oral surgeon has to cut lots of jawbone to remove the wisdom tooth.
2. Protection of the neighboring teeth: Your 2nd molars, which are next to the wisdom teeth, heal better and are less likely to be sensitive afterward.
3. Protect your Inferior Alveolar nerve (bottom wisdoms): There is a nerve near the bottom wisdom tooth and adding grafting material protects it and reduces complications.
4. Protect your sinuses (upper wisdoms): Your sinuses sometimes get perforated during wisdom removal and placing grafting/stitching, reduced the possibility of complex sinus infections.
Cons:
1. Cost: Bone grafts are never covered, so be prepared to spend $1,000+ to cover your bone grafting when doing 4 wisdom teeth extractions.
2. Pointless when simple extractions: If the wisdom teeth come out 1-2-3, without having to cut your jawbone, then a bone graft isn't really necessary.
In summary, if the wisdom teeth come out easily, then a bone graft is really not required. On the other hand, if they are difficult to remove, then a bone graft is well worth it. I hope this helps out, and good luck with your surgery!
@@johnjazayeri I guess that explains why he wants to do a bone graft on my horizontal tooth and not the other one where it is an easier pull. That explains a lot, thank you so much for your reply!! ☺️
Where you located?
It is possible do bone graft injecting bone where it need, without invasive surgery?
They harvest bone narrow, without surgery, that is more dedicated. Why not inject bone in local. The instrument is safe , no cut the skin, just perforated to get into bone.
Hi Alice. Someday, this will be possible. However, for the time being, this is really not an option. First off, sprinkling bone graft material is not enough to regenerate jawbone. If you were to simply inject graft powder non-invasively into a site, it would get rejected/eaten up without accomplishing any significant results. Don't forget, you need a blood source for the bone to grow. You can't really achieve any meaningful blood flow if you were to inject powder into the jawbone. This explains why dentists prefer to perform bone grafting when we remove the tooth (lots of blood from the tooth socket) or when we're doing a full-on surgery (again, blood flow from the surgery site). This is in contrast to lip injectors, right? That's because the lip has massive blood flow, but the jawbone, not so much. I'm sure that one day scientists will come up with a better way to graft jawbone. But for now, we're stuck with invasive dental surgeries to regenerate jawbone.
What is the price of bone graft per piece please let me know
Hi Padam. Bone graft prices vary significantly. Overall, bone grafts are expensive. This is because dentists have to purchase the graft material from a limited number of approved vendors. The cheapest bone grafts are known as a collagen plugs. These are best used for preserving 3rd molar sockets and repairing minor defects. Animal and human sourced bone grafts are much more expensive. The cost to the patient in the USA could be as little as a few hundred dollars for a simple case, and up to several thousands for a complex case (autogenous grafting with mesh/ screws, etc.)
Very well explained. Question. Can covid vaxinated cadaver bone contain remnants of the vaccine? Thanks
Hi Corbert. The answer is yes, theocratically speaking, vaccine remnants or COVID itself may be transferred via cadaver sourced bone graft material. There is a thorough cleansing process that animal sourced bone graft goes through, but it does not kill everything. I remember when I was in dental school and madcow disease was the feared disease of the time. You can also transfer madcow, or even HIV, from bone grafts theoretically. In reality, the odds of that happening is 1 in a million, if that. I personally wouldn't worry about it too much. However, if you are worried, you may be able to request a fully synthetic graft material. Syntenic graft is not as effective for complex cases, but they are perfectly sufficient for simple treatments. Talk to your doctor to see if this is an option for your mouth. Good luck!
Dear John, thank you for the well explained and detailed video!
I have a senerio question if that is ok.
I removed my dental implant 2 months ago and the surgeon didn't put bone graft into the socket.
Now it seems visually, that there is a valley. It even damaged my facial appearance - my face looks more sagged because of this.
CT scan shows if i re-do implant i have enough bone (yes, even after an implant removal)
I am afraid doctors won't agree to graft my area if medically there is no need.
I really want to cause it changed my face.
Does a bone graft to make jaw thicker is really makes surgery more complicated?
Can i graft the area post doing an implant? Or just pre-implant, or while putting it?
Thanks a lot
Hi there. I'm glad you learned something from my video! Let me summarize your situation: You had a failed dental implant which was removed/ fell out. Now you want a new implant. Nothing wrong with that! Honestly, time is the most important factor here. Once a dental implant fails, there is a very small "hole" left behind. Much smaller than the hole when you lose the tooth itself. If the site is not grafted immediately, then you don't need to worry about it. It will heal by itself. Just give it time (6 to 9 months typically). I know it sounds weird, but you do not need to disrupt the healing site to do an additional bone graft if it is healing on its own. Eventually your jawbone will heal and you will be ready for a new implant. Feel free to attach your X-ray, or email them to me, so that I can give you a more accurate assessment. There are exceptions of course, if the dental implant is very close to the IA nerve (lower back teeth) or sinuses (upper back teeth). In these situations there is a chance you may need additional grafting or a sinus lift. Even so, you're still better off waiting for the bone to heal by itself before determining if additional treatment is needed. I hope this helps and best of luck to you!
@@johnjazayeri Thank you so much for your answer! If you do online consultation, I would love to do that if possible, cause I'm a bit nervous about my dental situation.
I am not from the US.
So if you do that on a daily basis I would love to
Hello doctor,
Great explanation.
I have a question if you don’t mind
On May 31,2024 I have single implant done almost 5 days ago.
Because I have lost 1st molar tooth#46 that is almost 10 years ago. So I ask my doctor if I need bone graft on my molar and he said it’s better. He do countour bone graft (sinthetic)together with the implant. Only he put bone graft on the side of cheek .I ask him if I need membrane he said no.
He stitch it with nón resolvable suture.
My question is why the doctor don’t do bone graft with membrane?
Do I will have good results without membrane?
Even I follow the post instructions that you said on other vidio to how to takecare the implant for healing so I will have good result?
Appreciate your response.
And Thanks 🙏 for your effort for giving us guidance when it come to dental 😀
Hi there. The purpose of a membrane is to keep the graft from moving. A membrane is usually only needed when performing tooth extraction or extensive implant surgery. If the implant and graft are placed at the same time, you probably do not require a membrane. If the doctor can proximate your gum tissue and achieve primary closure, then the membrane is redundant. I hope this explains the situation.
I sure hope that my instructions help LOL! Best of luck.
Can bone grafts be done with teeth still in place ?
Hi Randall. Not really. Once you lose the bone surrounding a tooth it can not be replaced. Now there are certain situations where your dentist, or periodontist, can restore a small amount of bone next to a tooth if the defect is minimal. However, most of the time bone graft is only applicable when the tooth is removed and not with the tooth/teeth still present in the mouth.
I had 2 failed implants. They both came out somehow and became infected. So i had to get the infection cleaned out and a bone graft. Not going to lie, this is the worst pain i ever felt in my life.
My bone graft is coming out what to do
Hi Pathak. Bone graft is placed to help your body grow more bone. The actual graft material will be resorbed and rejected over time (in most situations). Don't panic if the graft is coming out. First off, it could be that some of the graft material is coming out while the rest remains inside the socket. Having said that, it's important to be very gentle and careful after bone graft treatment. Don't rinse vigorously, spit, cough, etc. or you will dislodge the bone graft. If the bone graft gets dislodged, there isn't much that can be done. I always go over these instructions carefully with the patient. I also place multiple stitches to try and approximate the gum tissue and keep the graft in place. Did you receive stitches after your surgery?
You're adorable!
I am 67 years old. In June 2022 ,I had a upper bridge with a tooth gone bad pulled. X4 months has passed. My dentist pulled what I thought was one tooth but my maxi facial surgeon says ,really about 2&1/2 teeth missing. He is doing my two implants.
. TO MY KNOWLEDGE ,my dentist,just took bridge out and pulled tooth and did no bone graft? I am healed from extraction and waiting for my implants apt. Should I question bone graft?? I am already in over 2.000 dollars Dental fee plus 700.00 flipper. Then surgeon charged 500.00 for consultation,CT -3D X-Ray and Ultrasound of the entire inside upper and lower teeth. I have no idea what the final cost is?? I am very concerned ab😊out many aspects going on. Should I insist on a bone 😊graft?? I do have a very deep hole in. my left upper jaw from extraction:(?. Thank you for your videos new subscriber here!!!👍
Hi Pamela. Sorry about your frustration. Difficult dental procedures require lots of patience! Regarding your bone grafting procedure, there really is no way to quantify bone graft. If your dentist claims he or she did the bone grafting, then you'd have to assume the grafting was performed. You can't really see the grafting on X-rays the way you can with a filling, crown or dental implant. Regarding the costs of the procedure, I'm afraid you still have a lot of expenses ahead of you. There is a cost for the implant screws, the abutments, and the implant crowns. I recommend that you request an upfront quote so that you can budget yourself accordingly. I usually give my patients a treatment plan that includes all the work which they're going to need with clear pricing. The pay as you go technique will cost you lots of $$$. Good luck and let me know how the rest of your treatment goes.
@@johnjazayeri thank you so much!! I am going to request a estimate of cost from both dentist! I
My dentist does not do implants. I am in Alabama ,wish you were closer. I would definitely use you!! Take care I will keep you up.
The first periodontics surgeon i meet, he quoted me to extract a tooth and bone graft: ~ 3800$, another implant fee will come later. I felt he was a killer, rather than a doctor.
Hi Han. Ouch! That is way too steep. This is why general dentists need to learn to remove their own teeth. I would've charged you half as much, probably even less, and given you the same results. Seriously, dentists, start pulling your own teeth. It'll save patients money and you get to earn more for your practice. So what did you end up doing?
Why aren't dentist talking about bone grafting before pulling?
Shouldn't we get choices?
Same with bridges, I thought all my bottom teeth were destroyed, so I told my new dentist ( I moved), to take them all. He requested an X-ray first. So I came back and he taken them over 4 weeks. Each time 4 taken.
Includes 4 strong healthy ones with no cavity or roots damage. It wasn't until a few weeks after that I saw on RUclips that this 4 good ones could have been used to hold a bridge.
....pulling healthy teeth sounds like malpractice!
😮
My dentist drew blood and used my own plasma for a bone graft.
Hi Craig. This technique is referred to as PRF, or platelet rich fibrin. This is a great option for cosmetic cases (front teeth) or teeth with massive bone loss. Most standard cases do well with a generic bone graft. However, more complex cases benefit from the PRF technique. Which dental implant was this for? How did it go?
My dentist won't do bone graft after he extracts my front upper tooth because he wants infection to clear up first. The tooth has suffered periodontal disease and I've lost a lot of bone and gum recession. Is my dentist right or should I go get a second opinion?
Hi Tee Tee. Tough question. It's one of two things most likely:
1. Your dentist is not really into preserving jawbone
2. Your situation is one where a graft is not necessary
If it's the first case, then sure, get a second opinion by all means. If your dentist does not do lots of surgeries it might be worth getting another dentist's opinion. But it could also be a situation where grafting won't help. Some patients have generalized periodontitis and their teeth have very little bony support and are completely loose. If this applies to you then you might not get a whole lot of benefit from the bone graft. There are cases where I elect not to place a bone graft because the hole left behind from the tooth extraction is so small that placing grafting material won't make much of a difference.
@@johnjazayeri My dentist has only done 20 implants ( I asked). He's only recently qualified. I will need a bone graft, he's told me I do. His plan is pull tooth , wait untill my body kills infection, then place the longest implant he can and then pack bone around. I'm worried about his inexperience.
Thanks for watching my video! Feel free to put your questions in the comments below and I'd happily answer them. Want to schedule an appointment to see me? My offices are located in Southern California (Orange County). Click below to schedule an appointment:
San Clemente Office: www.oceansightdental.com/book-your-appointment-online/
Newport Beach Office: genuine.dental/
How about lanap gum treatment with fillings and moderate periodontal disease., is it good?
Hi Imelda. LAPNAP is a non-invasive laser treatment for gum disease. So if you are suffering from gum disease, then this might be a good treatment for you.
PRF?
My aunt lost all her teeth. Gums shrunk badly. She went to the dentist for bone grafting consultation. She was told bone grafting is very painful, so now she is hella scared. Is that true?
Hi Ambereen. Your aunt's dentist is correct. Bone grafting to restore the missing jawbone is not a simple process. Especially when you have lost all of your teeth for a long time. The only way to restore the missing jawbone is to take bone from elsewhere in the body, such as the ribs or femur, and graft it in place. Ouch! Having said that, it is much easier to stop bone loss from progressing by placing dental implants. The "all-on-4 technique" allows you to replace your missing teeth without extensive grafting. This procedure relies on using the high-quality jawbone in the anterior region, the chin and nose, to secure implants that replace a full set of teeth. If she can't afford that, she can look into snap-on-dentures. By placing a few implants you can secure your denture for a more comfortable fit. Plus, the implants slow down the progression of bone loss. I think the question your aunt should be asking is "can I replace my missing teeth with implants to stop further bone loss?" There's a chance your aunt's dentist is not familiar with these complex dental treatments. This usually requires multiple consults, since only a handful of dentists perform these complicated treatments. I hope this helps and good luck to your auntie. If interested, you can post her X-rays and I can guide you in the right direction.
Dentists charge 500 to 600 for bone graft . Nobody charges 200.
Mine just charged 900
Some dentist just don't care
Great content. 10 out of 10 for enthusiasm however I do feel the video needs to be shorter and scripted.
What if your vegan.
And need to use animal sourced bone.
Hi SEZ. I've thought about this situation, although it hasn't happened to me as of yet. Some people may be 100% against using animal/human-sourced bone. What do you do in this case? First, I would try to avoid using animal/human-sourced bone and go with a synthetic alternative instead. If they are in need of dental implants, I would use a short, stubby implant that does not require as much bone. If however there is an absolute need to use high-quality grafting, then the only option is to harvest bone from your own body. This means you must choose a donor site (ramus of the mandible or chin), cut the jawbone from this donor site, and graft it into the required location. I must warn you that this is a very expensive and also painful procedure. I wouldn't do this unless it's an absolute last resort. Usually, there are alternative solutions to avoid having to take such a drastic measure. Feel free to include your X-rays if you need further guidance regarding your treatment. By the way, vegans typically have much better teeth than the rest of us meat eaters so hopefully, you won't need extensive dental treatment!
Vegan, well almost, here. I still take pills with gelatine when i have no other choice... and my ortho shoe maker doesnt offer vegan leather yet...