[leesal]

I had a bone graft done December 5, with some complications. In the midst of this, I switched oral surgeons.

Today I saw the oral surgeon who told me bone grafting didn't work. Bone grafting was done for 5 lower teeth. I asked him if we could redo it and he feels it will not work.

What other options do I have or should I get a second opinion?

[Bryanna]

Hi leesal,

If I remember correctly, you had several teeth missing on the lower for quite some time and your original dentist performed some major oral surgery to place bone grafting in those areas. He also extracted another lower tooth. You had one complication after another, a great deal of pain and infection. I think I even stated that the likelihood of the grafting being successful was slim due to the compromised state of your existing bone level. Have I got that right?

In order for a bone graft to successfully integrate with the jaw bone, the following criteria have to be present:

1) The existing bone needs to be viable and healthy. No disease can be present.
2) The existing bone has to be adequate in height and width to hold the graft during the growth of new bone. Bone that has become compromised in height and width due to infection or periodontal disease will often not be receptive to bone grafting. Bone that has receded, lost its height and width, due to bone loss from teeth being extracted months to years previously, will not be receptive to bone grafting.

Bone grafting does not take the place of jaw bone. It is not something than can be laid down like a blanket over existing bone. The graft is placed to stimulate a persons own growth cells to grow new bone in and around the graft material. If there is no way for the existing jaw bone to carry this graft material INSIDE of healthy, viable bone, then new bone will not grow into the graft because there is no stimulation for those growth cells to form. The graft material will either disintegrate or just sit on top of the existing bone. Either way, it is not solidified enough to hold an implant.

For the oral surgeon to tell you that the grafts have not taken and it would be fruitless to attempt that surgery again indicates that your existing jaw bone has receded to the point where it cannot hold the graft or grow new bone.

I know this is so difficult to understand and my heart goes out to you.
Your original dentist should have informed you of the huge risk you were taking with that bone grafting surgery. I am so sorry if he did not inform you of them.

What does this new surgeon suggest that you do? Does he feel the grafts should be removed?

Bryanna

Originally Posted by leesal

I had a bone graft done December 5, with some complications. In the midst of this, I switched oral surgeons.

Today I saw the oral surgeon who told me bone grafting didn't work. Bone grafting was done for 5 lower teeth. I asked him if we could redo it and he feels it will not work.

What other options do I have or should I get a second opinion?

[leesal]

Thank you Bryanna,

The oral surgeon said that there was hardly any bone there and that it was likely absorbed by the body or lost when the old surgeon went in to drill it down and get rid of infection. He said he would speak with my general dentist suggesting to me that I should look at more of a permanent partial. The one thing I didn't understand was why where the tooth was extracted bone didn't grow? Perhaps it was because of the infection being present would be my guess. Now that infection is gone, do you think it's possible to redo bone grafting where the tooth was extracted for the possibility of bone grafting success?

Originally Posted by Bryanna

Hi leesal,

If I remember correctly, you had several teeth missing on the lower for quite some time and your original dentist performed some major oral surgery to place bone grafting in those areas. He also extracted another lower tooth. You had one complication after another, a great deal of pain and infection. I think I even stated that the likelihood of the grafting being successful was slim due to the compromised state of your existing bone level. Have I got that right?

In order for a bone graft to successfully integrate with the jaw bone, the following criteria have to be present:

1) The existing bone needs to be viable and healthy. No disease can be present.
2) The existing bone has to be adequate in height and width to hold the graft during the growth of new bone. Bone that has become compromised in height and width due to infection or periodontal disease will often not be receptive to bone grafting. Bone that has receded, lost its height and width, due to bone loss from teeth being extracted months to years previously, will not be receptive to bone grafting.

Bone grafting does not take the place of jaw bone. It is not something than can be laid down like a blanket over existing bone. The graft is placed to stimulate a persons own growth cells to grow new bone in and around the graft material. If there is no way for the existing jaw bone to carry this graft material INSIDE of healthy, viable bone, then new bone will not grow into the graft because there is no stimulation for those growth cells to form. The graft material will either disintegrate or just sit on top of the existing bone. Either way, it is not solidified enough to hold an implant.

For the oral surgeon to tell you that the grafts have not taken and it would be fruitless to attempt that surgery again indicates that your existing jaw bone has receded to the point where it cannot hold the graft or grow new bone.

I know this is so difficult to understand and my heart goes out to you.
Your original dentist should have informed you of the huge risk you were taking with that bone grafting surgery. I am so sorry if he did not inform you of them.

What does this new surgeon suggest that you do? Does he feel the grafts should be removed?

Bryanna

[Bryanna]

Leesal,

<<The oral surgeon said that there was hardly any bone there and that it was likely absorbed by the body or lost when the old surgeon went in to drill it down and get rid of infection.>>

THE GRAFT WAS LIKELY REMOVED WHEN THE SURGICAL AREA BECAME VERY INFECTED AND THAT DENTIST SCRAPED THE BONE.

<<He said he would speak with my general dentist suggesting to me that I should look at more of a permanent partial. >>

THIS MAY BE THE ONLY OPTION YOU REALLY HAVE BECAUSE THERE IS NOT ENOUGH EXISTING JAW BONE TO HOLD A BONE GRAFT OR DENTAL IMPLANTS.

<< The one thing I didn't understand was why where the tooth was extracted bone didn't grow? Perhaps it was because of the infection being present would be my guess.>>

THAT EXTRACTED TOOTH WAS ALSO INFECTED AND HAD INFECTED THE BONE. SO IT WAS LIKELY THAT YOU ALREADY HAD BONE LOSS FROM THAT INFECTION AND THE TOOTH REMOVAL CAUSED FURTHER RECESSION OF THE BONE. THE IMMUNE SYSTEM WILL NOT ENCOURAGE THE GROWTH OF NEW CELLS TO GROW BONE IN AREAS OF BONE THAT ARE NOT HEALTHY.

<< Now that infection is gone, do you think it's possible to redo bone grafting where the tooth was extracted for the possibility of bone grafting success?>>

DUE TO THE SEVERITY AND PROLIFERATION OF YOUR BONE INFECTION, IT WOULD BE A SLIM CHANCE THAT A BONE GRAFT WOULD BE EFFECTIVE IN THAT #30 SITE. DID YOU ASK THE ORAL SURGEON ABOUT THAT AREA?

Bryanna

[leesal]

He feels grafting wouldn't take. I'm pretty upset about the situation considering I'm only 52, not 80.

What other options do I have? I've heard of Dentists using PRP (stem cell) which has been quite successful for some. Once bone is infected is there any way to get healthy bone with a situation like mine?

If you were in my situation Bryanna, what would you opt to do?

I'm even willing to travel out of state. Do you know of anything else that can be done?