Wisdom teeth removal, the extraction of the third molars from their bony sockets, is a common surgical procedure. The process of removing a tooth, especially one that is impacted or complicated, inevitably leaves a void in the jawbone. A bone graft is a dental procedure intended to preserve or rebuild the jawbone structure. This technique, often referred to as socket preservation, addresses the body’s natural response to tooth loss by filling the empty space with a material that encourages new bone growth.
Why Bone Grafts Are Discussed After Wisdom Tooth Removal
When a tooth is removed, the bone that once supported the root no longer receives the necessary stimulation, causing it to undergo a natural process called resorption. The jawbone begins to shrink in both height and width soon after the extraction. This process is particularly relevant following wisdom tooth removal because the extraction site can be quite large, especially if the tooth was deeply embedded or impacted.
The purpose of a bone graft is centered on “socket preservation.” By proactively placing bone graft material into the socket immediately after extraction, the procedure aims to maintain the existing contours of the jawbone. Maintaining the bone volume prevents the surrounding gum tissue and bone from collapsing inward.
A primary concern is potential damage to the adjacent second molar. Impacted wisdom teeth can sometimes cause significant bone loss and periodontal defects on the back side of this neighboring tooth. A graft helps restore the necessary bone support for the second molar, reducing its vulnerability to future problems like instability.
Factors Determining If a Graft Is Necessary
The decision to use a bone graft is not routine and depends on several clinical factors evaluated by the oral surgeon. Most straightforward wisdom tooth extractions do not require a graft, as the jaw heals adequately on its own. However, the presence of a large defect left behind by a deeply impacted tooth often makes grafting highly recommended.
The condition of the neighboring second molar is one of the most important considerations. If the wisdom tooth has caused significant bone loss or a pocket-like defect on the second molar’s root, a graft is often needed to prevent a long-term periodontal issue. This preservation ensures the long-term health and stability of the tooth directly in front of the extraction site.
The patient’s overall bone health and future dental plans also influence the decision. A graft may be considered if the patient has thin bone structure or if there is a possibility of future restorative work in that area. Furthermore, complications like large dentigerous cysts or extensive infection around the tooth necessitate a graft to rebuild the bone destroyed by the pathology.
What Happens During the Grafting Procedure and Healing
The bone grafting procedure is typically performed immediately following the wisdom tooth removal while the patient is still under anesthesia. The surgeon first cleans the empty socket thoroughly to ensure it is free of any debris or infected tissue. The graft material is then carefully placed into the socket to fill the void.
The graft material acts as a scaffold, providing a framework for the body’s own cells to grow new, healthy bone. These materials can come from various sources, including synthetic compounds, processed animal bone (xenograft), or donated human bone (allograft). Once the material is in place, it is often covered with a protective barrier, such as a resorbable membrane or a collagen plug, and the gum tissue is then sutured closed.
Initial recovery takes about one week, during which a patient may experience tenderness, swelling, and minor discomfort. Patients are instructed to avoid pressure on the site, stick to a soft diet, and avoid sucking motions that could dislodge the graft. Although initial healing is quick, the graft material needs several months to fully integrate and be replaced by the patient’s natural bone, typically requiring three to four months before the new bone structure is fully mature.