Bone Grafting 

Bone Grafting

After a tooth is extracted, the bone in that area begins to shrink. Up to 25% of bone volume can be lost during the first year, and the process continues more slowly in subsequent years.

If a tooth has been missing for a long time or was removed because of infection, the remaining bone may be insufficient to accommodate an implant of the required diameter and length.

Bone grafting is a surgical procedure designed to restore lost bone volume. At Iskusstvo Clinic in Moscow, it is performed by maxillofacial surgeons experienced in all modern augmentation techniques, ranging from the use of the patient’s own bone to contemporary bone substitute materials.

Bone Grafting Techniques

Autogenous Bone Grafting

The patient’s own bone is considered the gold standard from a biological perspective. Autogenous bone contains living cells and growth factors and provides the best integration potential.

Bone graft material is harvested from the chin symphysis, the mandibular ramus, or, when a larger volume is needed, from the iliac crest.

The main disadvantage of this technique is the need for an additional donor site.

Xenografts and Synthetic Materials

Bone substitutes derived from animal sources, such as Bio-Oss®, which is deproteinized bovine bone, or synthetic materials such as hydroxyapatite and tricalcium phosphate, can be used alone or mixed with autogenous bone.

These materials eliminate the need for a donor site and provide a scaffold into which the patient’s own bone gradually grows.

Block Bone Grafts

In cases of significant horizontal bone deficiency, a block of autogenous bone is fixed in place with titanium screws.

After integration, which usually takes three to six months, implant placement can be performed.

Laminate Technique and IDR Technique

Modern minimally invasive augmentation methods can restore deficient bone volume with less trauma to surrounding tissues and, in selected clinical situations, provide more predictable outcomes.

Simultaneous and Delayed Grafting

In some cases, bone grafting can be performed at the same time as implant placement if the deficiency is minor.

When bone loss is significant, grafting is performed first, and implant placement is postponed until the regenerated bone matures, typically after three to six months.

The treatment strategy is determined by the surgeon based on CT findings.

Rehabilitation

Following bone grafting, swelling may persist for five to ten days, and mild to moderate discomfort usually lasts three to seven days.

A soft diet is recommended for two to three weeks.

A follow-up visit is scheduled after seven to ten days for suture removal.

A control CT scan is generally performed four to six months later to evaluate the quality of the regenerated bone before implant placement.

Contraindications

Contraindications include active inflammatory conditions within the oral cavity, uncontrolled systemic diseases, and treatment with bisphosphonates used for osteoporosis or certain oncological conditions, which require a special management protocol.

Smoking significantly compromises grafting outcomes and is strongly discouraged.

The final decision regarding treatment is made by the surgeon.

Frequently Asked Questions

Is It Possible to Avoid Bone Grafting?

Sometimes, yes.

If there is sufficient bone volume, grafting is unnecessary.

In selected cases, short or narrow implants adapted to reduced bone volume can be used.

Whether grafting can be avoided is determined during consultation based on CT imaging.

Where Is the Bone Taken From?

For small defects, bone is harvested from the chin symphysis or the mandibular ramus through intraoral approaches, avoiding any external incisions.

When a larger volume is required, bone may be harvested from the iliac crest.

In most situations, bone substitute materials are used, eliminating the need for a donor site.

Is Bone Grafting Painful?

The procedure itself is painless because it is performed under anesthesia.

After surgery, patients typically experience mild discomfort comparable to that following tooth extraction, which is well controlled with standard pain medication.

Is It Necessary to Wait Six Months Before Implant Placement?

Not always.

With minor simultaneous grafting, the implant can often be placed immediately.

When a substantial amount of graft material is used, a healing period of three to six months is required for integration into the patient’s bone.

The exact timeline is determined individually by the surgeon.

Book a Consultation

Book a consultation. The surgeon will evaluate the extent of bone deficiency using CT imaging and recommend the most appropriate method of bone reconstruction.