Hi asmitty,

I will post my reply in bold.

<<<<1. I'm trying to do a cost benefit analysis of getting the bone graft this coming Tuesday. On the one hand if it takes, it will save me up to 1,500 dollars vs a sinus lift. On the other hand it could become infected and fail. Assuming the latter, whats the worst that happens if it fails? >>>

ONE) A BONE GRAFT IS A LOT EASIER THAN A SINUS LIFT.

TWO) A BONE GRAFT WOULD STILL NEED TO BE DONE WITH A SINUS LIFT.

THREE) WHEN A BONE GRAFT BECOMES INFECTED IT CAN MAKE YOU QUITE ILL AS COULD ANY INFECTION. GENERALLY ANTIBIOTICS ARE GIVEN TO TRY AND HANG ON TO THE GRAFT.. .BUT SOMETIMES THE MEDS ARE GIVEN MULTIPLE TIMES WHICH IS NOT IDEAL FOR YOUR IMMUNE SYSTEM. IF THAT METHOD FAILS THEN THE GRAFT HAS TO BE SURGICAL REMOVED... MORE DENTAL CHAIR TIME AND MORE $$.

SO IF THE JAW BONE IS HEALTHY AT THE TIME THE BONE GRAFT IS PLACED AND THE SURGERY TO PLACE IT IS VERY STERILE AND YOUR POST OP CARE IS VERY GOOD, THE SUCCESS RATE OF THE GRAFT IS UNMEASURABLE.

<<<I know the graft could temporarily harbor infection due to a lack of blood flow; but wouldn't blood flow eventually get integrated into the graft and remove the "potential" infection? Or, are there other long term concerns regarding the graft and infection that I am missing?>>>

THE GOAL OF PLACING THE GRAFT IS TO SCRAPE THE BONE AND TISSUE DURING THE SURGERY TO OBTAIN A HEALTHY BLOOD FLOW AND THEN PLACE THE GRAFT INTO THAT BLOODY SITE. THE BLOOD KNOWS TO CLOT QUITE READILY WITHIN THE GRAFT MATERIAL HELPING TO HOLD IT IN PLACE. A COLLAGEN PLUG OR MEMBRANE IS ALSO PLACED IN THE SOCKET TO HOLD THE CLOT AND GRAFT IN PLACE. PROVIDING THE JAW BONE IS HEALTHY TO BEGIN WITH (THAT IS A MUST!!) AND THE BLOOD FLOW DURING THE PLACEMENT IS ABUNDANT, SURGERY IS STERILE AND POST OP CARE IS GOOD... THE GRAFT SHOULD BE OKAY. THE ONLY OTHER ISSUE COULD BE IF YOUR BODY REJECTED THE GRAFT DUE TO INCOMPATIBILITY ISSUES OR ANOTHER AUTO IMMUNE REACTION OCCURED.

<<<<2. Also, with regards to an implant in the future.... Do you think the bacteria that surrounds an implant post has a greater chance of gaining access to systemic circulation than the bacteria that is already in the mouth as it is?>>>>

NO, NOT UNLESS THERE IS A COMPROMISING SITUATION EITHER WITH THE IMPLANT SITE AND/OR THE PATIENTS IMMUNE SYSTEM WHICH WOULD CAUSE AN INFLAMMATORY RESPONSE AND/OR INFECTION.

<<<<3. Also, if I decide I'm going the bridge route, I assume I would never need a graft anyway, correct?>>>>

NOT NECESSARILY. THERE IS ALWAYS SOME DEGREE OF BONE LOSS WITH EVERY TOOTH EXTRACTION. GENERALLY THE LOSS CAN BE 50% OR GREATER AFTER THE INITIAL HEALING AND THEN CONTINUES TO RECEDED OVER TIME.
WHEN A GRAFT IS PLACED, THE IMMUNE SYSTEM SENDS CELLS TO GROW NEW BONE INTO THAT GRAFT. THE GRAFT BECOMES YOUR OWN BONE REDUCING THE OVERALL AMOUNT OF BONE LOSS.

HOWEVER, OVER TIME THIS BONE TOO WILL RECEDE JUST LIKE ANY OTHER BONE THAT HAS NOTHING TO SUPPORT IT. HOWEVER, THIS BONE LOSS IS USUALLY NOT AS GREAT AS IT IS WITHOUT HAVING PLACED THE GRAFT MATERIAL.

Does that seem clear to you? Or do you want more information or have other questions?

Bryanna