Nathan T Cary, DDS
Phillip G Cary, DDS
CANANDAIGUA ORAL SURGERY, PC
500 North Main Street, Canandaigua, NY 14424, 585.394.3322
Bone & Soft Tissue Grafting
Bone and soft tissue grafting refers to surgical procedures that are performed to augment or reduce the size or volume of bone and/or soft tissues. Augmentation of bone is done when disease or trauma has resulted in insufficient remaining bone to support planned dental reconstruction or has created general structural deficiencies that compromise patient health and comfort. Augmentation of soft tissues is done when there is a need for better quantity or quality of soft tissues in an area of the mouth (gum tissue, cheek lining, floor of mouth lining, palate surface).
Reduction of bone or soft tissues is done when conditions exist or develop that interfere with dental health or prosthetic reconstruction. Soft tissue reduction is sometimes required for such conditions as:
A. Enlargement (due to medications or irritation)
B. Excess soft tissue when full or partial dentures are planned
C. Access to impacted teeth to attach orthodontic devices (braces)
D. To allow your dentist to prepare teeth for crowns or place dental restorations
Bone and/or soft tissue grafting of the jaws has become commonplace in the practice of oral surgery. This is at least in part due to the rapid increase in utilization of dental implants that has occurred over the past 30 years. Proper size, positioning, and general bioengineering for long term implant health and survival will often depend upon returning a compromised anatomy to a more normal configuration.
There are a number of different types of procedures to consider when planning bone or soft tissue grafting of the mouth. Some procedures involve the use of the patient’s own bone/soft tissue (autografts) transferred from one location to another. Other procedures can use human donor bone/soft tissues (allografts) or use other bone/soft tissues obtained from other mammals (xenografts). In addition, a category of materials known as alloplasts are composed of materials such as ceramics, mineral aggregates, bioactive glasses, polymers, and metals. Grafting, if required, is often done when implants are placed, but will on occasion require a separate procedure. Sometimes grafting is completed in multiple procedures. Procedures are almost always performed in the office using either local anesthesia or intravenous sedation or general anesthesia.
We routinely perform bone grafts and soft tissue grafts for dental implant therapy. Sinus floor bone augmentation and ridge width or height augmentation are the most common bone grafting procedures. Gingival (gum tissue) grafting is also commonly done here to address problems with the amount or type of tissues that surround and support natural teeth or implants. Each case is unique and requires careful evaluation and planning. An initial evaluation and consultation is a required part of the treatment protocol. This will allow for complete examination, radiographic and/or photographic imaging as needed, and development of the most appropriate treatment plan.