Are bone graft and guided tissue regeneration necessary for wisdom teeth extraction?
 

Dear all,

I had two wisdom teeth on the left side removed. Days ago when I was reviewing my insurance claim, I realized that I was charged for about $500 in total for two procedures that I was unaware of until I saw the claim. And they are not covered by my insurance. One is bone graft and another is guided tissue regeneration.

I called the dentist office before I made a decision to extract my wisdom teeth, to find out required procedures and cost under my insurance. They never mention that I could need these two procedures. They have my x-ray pics.

During the extraction, the dentist did mention that he already put some bone graft to help my bone to grow. Since I'm not a dental professional, I didn't even doubt whether it's necessary. I didn't know it's separate procedure either and didn't know it will be charged separately from the extraction fee. As for the tissue regeneration, I do not recall whether he informed me of it.

And after the extraction, when I was paying my out-of-pocket amount, the office manager (same lady who picked up my consulting call) didn't mention the two procedure either.

When I saw the claim, I asked the dentist office. She replied as below:

"The only reason we used 2 procedures for the bone graft is because insurance companies itemize everything and we are forced to comply with their policies, especially since we are contracted with them. A bone graft requires guided tissue regeneration because it ensures that the bone has time to form before the tissue can fill in the space where the bone should be."

It makes me puzzled. My questions:

1. Is bone graft really necessary for wisdom teeth extraction? I did some research online. Most opinion says it's unnecessary unless my teeth was totally impacted and covered by bones. Bone graft is usually used for implant placement or denture stabilization (sorry I can't post link to provide the source). Referring to wikipedia, I believe my wisdom teeth were not impacted. Although my bottom wisdom teeth was mostly covered by gum and erupted toward the molar next to it, the top part (about 3mm) was out of the gum.

2. According to the manager's reply, a bone graft requires guided tissue regeneration. Is it always the case?

Thanks very much for your help!

MQ

Additional Info on my teeth
 

I was reading the conversation between Bryanna and Marshur about gum tissue graft and realized that I should provide some information of my teeth.

I'm 24. My teeth have been pretty healthy. The extracted two wisdom teeth didn't hurt or anything. The only reason I decided to extract them is that the bottom one was heading towards the molar next to it. It didn't push the molar but it creates a space where food always stuck. It's hard for me to rinse them out after each meal when a big piece of meat is stuck.

After the teeth were extracted, I saw that the bottom wisdom teeth has small cavity and the upper one has a bigger cavity. But they never bothered me (never hurt).

The molars next to the wisdom teeth were and are always fine.

Never had gum issue for the wisdom teeth and molars next to them.

I had brace before but the brace didn't touch the wisdom teeth nor the molars next to them.

One thing I forgot to mention is that the dentist cut my gum to extract the wisdom teeth at bottom. He used non-resorbable suture.

Is this the reason that I possibly needed bone graft and guided tissue regeneration (resorb-able)?

Thanks,
MQ

One correction.
 

Hi,

Sorry for so many posts. I was doing more research and realized that I might make a wrong statement.

I was saying that my wisdom teeth was not impacted. After reading more, I think it might not "totally impacted", but is indeed impacted. I think my situation was "Mesioangular impaction - the tooth is angled towards the front of the mouth. Approximately 44% of wisdom teeth impactions are of this type." *edit*

Thanks,
MQ

Hi MQ,

I am in the dental field and can offer you some information here.

Regarding the removal of your wisdom teeth and the placement of bone grafts along with GTR. Depending on the individual case, both of these procedures may be warranted to encourage the growth of new bone as well as to direct the gum tissue to heal properly. If the dentist felt that you had a considerable void in the bone from the wisdom teeth and/or visually he could see that there was some bone loss on the back (distal portion) of the root of the second molars, then both of these procedures would be warranted.

Also the receptionist was correct in that the procedures need to be listed individually according to the insurance companies. Depending on your insurance policy, some or all of the procedures would be covered.

I would expect that your dentist felt these procedures were necessary to improve the overall outcome of the surgery.

I do think you should have been informed prior to the extractions of the possibility for both procedures along with the cost.

Bryanna