A dental bone graft involves placing material into the jaw to encourage the body’s natural bone growth process. While often associated with preparing the jaw for a dental implant, grafting is not solely a precursor to implant placement. Even when no implant is planned, a graft may be necessary to maintain the integrity of the jawbone or facilitate other dental restorations. The procedure restores lost bone volume and density, often due to tooth loss, gum disease, or trauma.
Why Socket Preservation is Necessary After Tooth Removal
The primary reason a bone graft might be recommended following an extraction, even without an immediate implant plan, is to prevent the rapid deterioration of the jawbone. The bone surrounding a tooth, known as the alveolar ridge, exists specifically to support the tooth root. Once a tooth is removed, the bone loses its necessary function and stimulation, triggering a natural biological process called resorption.
This resorption process is swift, with the jawbone beginning to shrink almost immediately. Studies show that much of the bone loss occurs within the first six months to 18 months after the tooth is lost, continuing gradually thereafter. The bone shrinks both vertically and horizontally, leading to a significant reduction in the height and width of the alveolar ridge.
To counteract this, dentists perform a procedure called socket preservation, or ridge preservation, at the time of extraction. This involves placing bone graft material directly into the empty socket and covering it with a membrane. The graft acts as a scaffold, holding the space and encouraging the body’s bone-forming cells to generate new bone tissue instead of allowing the socket to collapse.
Maintaining the bone’s dimensions is important for stability. Without socket preservation, the ridge can become narrow and sharp, making the area less ideal for any future restoration, even a simple partial denture. The bone graft stabilizes the area, preventing the dramatic dimensional changes that occur when the socket is simply left to heal.
Grafting to Save Teeth and Prepare for Prosthetics
Beyond preserving the jaw structure after an extraction, bone grafting serves two therapeutic purposes that do not involve dental implants. One use is to support existing teeth compromised by disease. Periodontal disease, a chronic bacterial infection, causes the destruction of the bone that anchors teeth in the jaw.
When the supporting bone is lost, deep, vertical defects can form around the tooth root, leading to looseness and eventual tooth loss. Grafting material is placed into these specific defects to regenerate lost bone support, stabilizing the tooth and preventing its extraction. This procedure, often called guided tissue regeneration, reinforces the tooth’s foundation, allowing it to remain functional.
Another application is preparing the mouth for non-implant prosthetic devices, such as fixed bridges or removable dentures. Significant bone atrophy can make wearing a denture uncomfortable, unstable, or impossible. When the jawbone shrinks substantially, the residual ridge can become thin and pointed, causing chronic irritation and soreness under the denture.
In these cases, a ridge augmentation procedure uses bone grafting to increase the volume of the jawbone, smoothing out sharp contours or increasing the height of the ridge. This improved bone contour provides a much better fit, improved stability, and greater comfort for the denture, which rests directly on the jawbone.
The Impact of Untreated Bone Resorption
Refusing a recommended bone graft means allowing the natural process of bone resorption to continue unchecked, leading to long-term functional and aesthetic consequences. When the jawbone is not stimulated by a tooth root or a graft, the body reabsorbs the bone minerals. This can result in a loss of up to 25% of the jawbone tissue volume within the first year after tooth loss.
Over time, this significant bone atrophy alters the structure of the lower third of the face. The loss of underlying bone support causes the overlying facial tissues to collapse inward, leading to a “sunken” or prematurely aged appearance. This includes thinning of the lips and increased wrinkling around the mouth, as the facial profile loses its natural support.
Functionally, unmitigated bone loss severely compromises the ability to wear removable prosthetics. As the jawbone shrinks, dentures lose retention and stability, leading to movement during speaking or chewing. This movement can cause chronic friction, persistent pain, and the need for frequent relining or replacement.
Furthermore, the loss of a tooth causes the adjacent teeth to lose support and shift their positions. Surrounding teeth may tilt or drift into the empty space, disrupting the bite alignment and creating new problems like increased wear, misalignment, and difficulty cleaning. Bone grafting, even without an implant, safeguards long-term oral function and maintains facial integrity.