What is bone augmentation?

Bone augmentation is a dental procedure to increase the amount of bone in the jaw, often necessary before dental implants when the patient does not have enough bone tissue to support the implants. This situation can occur due to tooth loss, periodontal disease, injury, or natural bone resorption that occurs after tooth loss. The goal of bone augmentation is to create a solid foundation for dental implants, allowing for a stable and long-lasting dental restoration.

How Does Bone Augmentation Take Place?

The bone augmentation procedure involves several key steps:

Assessment and Planning: A detailed examination, including x-rays or CBCT scans, is performed to assess the density and amount of existing bone. This helps determine what type of increase is needed.

Anesthesia: The procedure is usually performed under local anesthesia, although sedation or general anesthesia options may be available depending on the case.

Access to Bone: An incision is made in the gum to expose the area of bone where augmentation is needed.

Addition of Augmentation Material: The bone augmentation material, which can be autogenous (taken from the patient), allogeneic (donor bone), xenogeneic (animal bone) or synthetic bone, is placed in the required area.

Closure: The gum is closed over the augmentation area, and sutures are placed.

Healing: A healing period is necessary to allow the augmentation material to integrate into the existing bone, which may take several months.

Bone Augmentation Methods

There are different methods of bone augmentation, chosen depending on the specific patient situation and the extent of bone loss:

Bone Graft: Uses bone fragments to increase the height or width of the jaw bone.

Sinus Lift: A specific procedure to augment the bone in the posterior region of the upper jaw by raising the floor of the maxillary sinus and placing bone graft material.

Guided Bone Regeneration (GBR): Uses barrier membranes to protect the graft site and encourage natural bone growth.

Osteogenic Distraction: A technique that induces the growth of new bone by gradually stretching existing bone tissue.

How is Bone Augmentation Surgery Performed?

Bone augmentation surgery takes place in several stages, designed to increase the amount of bone in the jaw where there is insufficient bone. Here are the broad outlines of the process:

Consultation and Planning: Before surgery, a detailed assessment, including x-rays or a CBCT scan, is performed to determine the amount of bone needed and the best type of graft to use.

Preparation: The area is prepared under local anesthesia, conscious sedation, or general anesthesia, depending on patient preference and surgeon recommendations.

Bone Access: An incision is made in the gum to expose the jaw bone where the graft is needed.

Graft Placement: The bone graft material, which can be autogenous (from the patient), allogeneic (from a human donor), xenogeneic (from animal origin), or synthetic, is placed in the required area.

Closure: The gum is closed over the graft area, often with the help of barrier membranes for guided bone regeneration, and sutures are placed.

Healing Period: Healing time is required to allow the graft to integrate with the existing bone, which can take several months to a year, depending on the extent of the graft and the method used.

The Healing Process After Bone Augmentation Surgery

After bone augmentation surgery, the healing process is crucial for successful graft integration. Here’s what patients can expect:

Rest: It is important to limit physical activity immediately after surgery to reduce the risk of bleeding and swelling.

Pain Management: Pain medication will be prescribed to manage any post-operative discomfort.

Oral Care: Specific instructions on oral care, including gentle cleaning of the surgical area, will be provided by the surgeon.

Diet: A soft diet is recommended initially to avoid putting pressure on the graft area.

Follow-up: Follow-up appointments will be necessary to monitor healing and bone graft integration.

How long is bone augmentation effective?

The effectiveness of bone augmentation, in terms of providing a solid foundation for dental implants, can last a lifetime, provided the graft integrates properly and the patient maintains good oral hygiene. The long-term success of bone augmentation also depends on factors such as smoking, systemic diseases, and the overall health of the gums and remaining teeth. Careful attention to oral health and regular visits to the dentist are essential to maintaining the health of the bone graft and dental implants.

Things to Consider After Bone Augmentation Surgery

After bone augmentation surgery, several considerations are important to ensure optimal healing and long-term success of the procedure:

Following Post-Operative Instructions: It is crucial to follow the instructions provided by the surgeon, especially regarding wound care, pain management and dietary restrictions.

Oral Hygiene: Maintain gentle but effective oral hygiene around the operated area to prevent infection without disturbing the graft site.

Limitation of Physical Activity: Avoid strenuous physical activities soon after surgery to reduce the risk of bleeding, inflammation and graft displacement.

Diet: Adopt a soft diet to avoid putting pressure on the graft area during the first days or weeks after surgery.

Stopping Smoking: Smoking can hinder the healing process and bone graft integration. It is strongly advised to stop smoking before and after the procedure.

Follow-up Visits: Attend all recommended follow-up visits to allow the surgeon to monitor healing and graft integration.

Who are suitable candidates for bone augmentation?

Suitable candidates for bone augmentation surgery include:

Patients with Bone Loss: Those who have experienced significant bone loss in the jaw due to tooth loss, periodontal disease, injury, or other conditions.

Dental Implant Candidates: Patients who desire dental implants but do not have sufficient bone to securely support the implants.

Patients with Bone Defects: Those with congenital or acquired bone defects that may affect the aesthetics and functionality of the jaw.

Patients in Good General Health: Good overall health is important to withstand anesthesia and for optimal healing.

Factors Affecting Bone Augmentation Surgery

Several factors can influence the success of bone augmentation surgery, including:

Quality and Quantity of Remaining Bone: The presence of minimal bone is necessary to support the graft.

General Patient Health: Systemic conditions, such as uncontrolled diabetes or certain autoimmune diseases, may affect healing.

Oral Hygiene: Good oral hygiene before and after surgery is essential to prevent infection and promote healing.

Graft Technique: The choice of graft material and surgical technique can influence the outcome of the procedure.

Smoking: Smoking is a major risk factor that can compromise healing and bone graft integration.

The Relationship between Bone Augmentation and Implant Treatment

Bone augmentation plays a crucial role in the success of implant treatment, especially for patients who do not have sufficient quantity or quality of bone to support dental implants. Here is how these two procedures are interconnected:

Implant Site Preparation: Bone augmentation creates a strong foundation for implantation, by increasing the height and/or width of the jaw bone where there is insufficient bone.

Improved Implant Stability: Adequate bone volume is essential for the long-term stability of implants, reducing the risk of implant failure.

Expanded Implant Placement Options: Bone augmentation allows for the placement of implants in areas previously considered inadequate due to bone loss.

Improved Aesthetics: Sufficient bone volume ensures adequate contour and support for prosthetic restorations, resulting in a more natural aesthetic result.

Bone Augmentation: Success Criteria and Expected Results

Success criteria for bone augmentation include:

Bone Integration: Successful integration of the graft material into the existing bone, forming a solid foundation for future implants.

Sufficient Bone Volume: Obtaining sufficient bone volume to support dental implants securely.

Functionality and Aesthetics: Restoration of masticatory function and achievement of a satisfactory aesthetic result with implants and final prostheses.

Long-Term Durability: Maintaining bone and implant stability over the long term, with functionality and aesthetics preserved.

Expected outcomes include an improvement in the patient’s quality of life, the ability to chew and speak comfortably, and an aesthetically pleasing smile.

Bone Augmentation Price 2024

In 2024, the cost of bone augmentation may vary depending on several factors, such as the extent of bone loss, the type of graft material used, and the location of the clinic. Here is an indicative price range:

Small to Medium Increase: Costs can vary from 500 to 3,000 euros, depending on the complexity of the procedure and the grafting material.

Major Bone Augmentation: For cases requiring major augmentations or special techniques such as sinus elevation, costs can range from 2,000 to over 5,000 euros.