Bone augmentation in the lower jaw: procedure, duration and complications

Sufficient jawbone is necessary for dental implants to sit firmly in the jaw. If the tooth has been extracted a long time ago, however, or if the extraction of the tooth was traumatic for the bone; the bone might not be present anymore with a sufficient volume to support a dental implant. In order to ensure the long-term stability of the dental implant a bone augmentation might be needed in those circumstances. In this article we will try to explain just how a bone augmentation works, how long the treatment takes and exactly what complications may occur.

Building up the bone using the body’s own bone (otherwise known as a block graft)

In contrast to the upper jaw, the lower jaw bone is extremely hard plus the blood supply is less than in the upper jaw. This is why the bone grafting in the lower jaw often takes greater professional time and skill to deliver successfully for the affected patient. Know that there is a selection of materials available for your dentist to consider in order to regain the original bone anatomy in all its structural features. When small areas of the jaw need to be filled; the body’s own bone drilled out specifically for the purpose of dental implant placement or a smaller quantity of the bone removed from the surface can be mixed with natural or artificial bone substitute materials. In case of larger defects, when larger areas present which require filling, a bone block is removed from the posterior (rear) area of the lower jaw and so transplanted to the identified site of the procedure. 

If a major area of missing bone within the lower jaw is identified, it may become necessary to remove sufficient quantities of bone from the pelvic crest. If we find that the entire jawbone is missing, as a result of cancer treatments, for example, parts of the shinbone are removed completely and are used to reconstruct the lower jaw. Both major procedures are always performed under general anaesthesia. In contrast, smaller bone augmentations or block bone grafts are performed under local anaesthesia. 

Just how long does it take to perform a bone grafting procedure 

The actual duration of the procedure plus the necessary professional planning time it takes to precisely conduct it for the best possible clinical results can vary. Timings plus establishing exactly when the subsequent dental implant can be placed depends on the initial findings as obtained during consultation plus the success of the bone augmentation itself as it adheres and heals in place. Note that bone augmentation usually takes between 1-3 hours in clinic, depending on the extent of the bone loss as presented. 

Post-procedure, the newly grafted bone needs between 3-6 months healing time before the recommended dental implant can finally be securely fitted. In the case of resolving sites within the jaw where a smaller amount of bone is missing, the dental implant can be placed simultaneously with the bone augmentation technique.

Possible complications to be aware of after a bone grafting procedure in the lower jaw

We would advise all our patients that a surgical procedure always involves a certain risk. These risks generally include wound healing complications and the potential onset of infections. We realise from our professional experience that during implantation in the lower jaw, the route of the mandibular nerve plays a decisive role – this anatomical principle also applies during bone augmentation procedures. Rest assured that with a 3D X-ray, your dentist can discover the exact course of the nerve prior to the operation, so that any risk is mitigated before we start. In addition, a 3D X-ray enables your dentist to pre-plan the operation at every stage and on a step by step basis. 

Are there alternative treatment options to a bone grafting procedure 

Please be advised that, unfortunately, there are no alternatives or indeed less invasive treatments currently available within modern dentistry to restore the volume of the jaw bone. As a preventative measure, as a patient, we would suggest that you can often avoid a bone grafting procedure (necessary prior to receiving a dental implant) if you can contact your dentist or oral surgeon immediately after experiencing tooth loss. It is prudent to act fast because as more time passes, more bone becomes naturally resorbed by the body at the tooth loss site. 
Should you have any concerns or wish to raise any questions regarding bone augmentation procedures available at Wimpole Street Dental Clinic, please do not hesitate to contact us for the best professional advice.