Small, medium & large: A simple guide to bone grafts

Oral surgical procedures such as dental implants make it possible to restore one or all of a patient’s missing teeth in just one day. However, not everyone is an immediate candidate for this type of restorative solution.

In cases where patients have experienced major bone loss, grafts must be completed first in order to strengthen the jawbone. Over time, bone density can be improved until it is sufficient enough to support titanium anchor posts. Thanks to modern bone grafting techniques, more patients than ever can qualify for dental implants.

What causes deterioration of the jawbone?

Patients who suffer from jawbone atrophy are generally those with periodontal disease, osteoarthritis or extensive tooth loss. When tooth sockets are empty for prolonged periods of time, the body does not regenerate enough new bone tissue to retain proper bone density.

As we bite and chew with our natural teeth, pressure is transmitted from the crown down through the root and into the bone. This pressure signals your body to regenerate new bone material. The longer a socket remains toothless, the more severe the atrophy.

3 types of bone grafts

The basic premise behind a bone graft is simple. A combination of demineralized human bone granules and the patient’s own bone material is used to initiate new bone growth in weak areas of the jaw.

Depending on the size of the graft, bone material is gathered from the jawbone near the wisdom teeth or from the patient’s hip or tibia.

3 types of bone grafts are applied to prepare a patient’s mouth for future restorative procedures: Little, Medium & Big.

Small bone grafts

Used in cases where a patient has lost a single tooth, a small bone graft is more of a proactive procedure than a restorative one. A small bone graft is generally applied when a patient has recently lost a tooth, either via extraction or because it was knocked out and unable to be saved.

Once a tooth has been removed, demineralized human bone material is packed into the tooth socket up to the height of surrounding bone. Over the course of several weeks, the patient’s own bone will replace the grafted material, preparing the area for a future implant.

With small bone grafts it is not necessary to use any of the patient’s own bone.

Medium bone grafts

In cases where a patient has been missing one or several teeth for an extended period of time, a medium bone graft can be used to repair bone atrophy and regenerate new bone.

As gum tissue will have grown over empty sockets, a small incision must first be made to expose the bone. The patient’s bone surface is then prepared for the graft, which requires a small amount of the patient’s own bone material for best results.

It is possible to perform medium bone grafts on several teeth at the same time.

Large bone grafts

When atrophy severely affects the width and height of the jawbone, a large bone graft must be performed to reshape the bone slowly over time. Patients who have worn dentures for many years, for example, may lose so much bone that their dentures become unusable.

Given the size of large bone grafts, additional patient bone must be gathered from other parts of the body, usually the hip or tibia.