Extraction and Implant with a Cadaver/Donor Bone Graft? (teeth, implants, molar)

[Eugene80]

This sounds really scary, but I'm scheduled to undergo tooth extraction (and an implant 6 months later) for Molar Tooth #18 which will involve a bone graft to solidify the bone in preparation for the implant.

The bone graft will be allografts i.e. cadaver bone from a donor bank. Isn't it possible to have a bad immune reaction to that? Even if the material is sterile and disinfected, what if your immune system rejects foreign DNA? Wouldn't you develop elevated white blood cells (WBC) or antigens or something like that, maybe fever or rashes? How about cancer or Lyme disease?

The dentist made no mention of synthetic materials also available for accomplishing the same task, which are safer and won't trigger an immune response, such as calcium bisulfate. Why is that? And why not do an implant sooner, to avoid this 6-month preservation? The bone can grow immediately around the implant.

Surprisingly I haven't been able to find much on this topic online. Most info out there is about cavities, crowns, and root canals. Do people usually do this? Is this a common procedure? Or is extraction normally done without bone grafting?

[daliowa]

Good overview of dental implant process on Mayo Clinic site:
https://www.mayoclinic.org/tests-pro...t/pac-20384622

[daliowa]

If you have concerns, or unanswered questions, about the implant that you are getting than I suggest that you schedule some time with your dentist to address all of your concerns.


A good dentist will make sure that you fully understand the treatment plan, and the reasoning behind.

[ndcairngorm]

Very very often on implants, the dentist will use bone graft material. It is such a common practice I cannot imagine there is any danger, but perhaps someone will have some anecdotal information. Both I and my husband have had this procedure with no ill effects.

[Eugene80]

Thanks for the answers. Ndcairngorm, since you said you had implants, was everything OK with nerve safety? This is an issue for lower teeth. I'm now getting more concerned about the nerve impact for lower implants than about bone graft materials.

[utsci]

I had an extraction about a year ago by our general dentist, a guy who has been around a while and stays current. During the simple extraction #20 he placed a synthetic bone graft. Fast forward to needing an oral surgeon for a tooth that was complicated (root canal, 2 apicos, seemingly chronic infection, now cracked and leaking) so I decided that I would have both implants done by the oral surgeon. The complicated extraction done by the oral surgeon has healed up nicely within 6 months and I had the implant placed last week. Not sure what type of graft material he used but indicated it was not synthetic. He felt that a synthetic graft is usually used for holding space. To prepare for the implant on #20, we are now dealing with a failed graft. Since the extraction there has been a small exudate and the graft has not filled in as nicely as it should. While I was numbed up on the same side for the implant, the oral surgeon cleaned out the synthetic graft and we will move on from there.

Not everyone reacts well to a synthetic product.

[ndcairngorm]

Originally Posted by Eugene80

Thanks for the answers. Ndcairngorm, since you said you had implants, was everything OK with nerve safety? This is an issue for lower teeth. I'm now getting more concerned about the nerve impact for lower implants than about bone graft materials.

Sorry Eugene, somehow I missed your question when it came in. It was my hubby who had the lower teeth done, and he's absolutely fine - it's 3 to 4 years now and not a single problem. However, the dentist who did the whole thing was very conscientious and sees him every year (forever) without charge, just to make sure all is well.

[NYC refugee]

I was told I had cow bone. It was in powdered form and just packed in and stitched closed. I can't say it caused me any problems, but I also can't say it did me any good as the last two times I was at (different) dentists, they thought I should have more work where I had the original bone loss. I said I'd consider it if they could tell which side I had had the graft on and which I hadn't and both refused to guess. That was $500 I won't get back.

[bart0323]

Bone grafting in dentistry comes in many forms:


Autograft - natural bone; the donor and recipient are the same person i.e. the doctor uses bone from another part of your mouth and/or body
Allograft - natural bone; the donor and recipient are the same species i.e. cadaver bone from a bone bank
Xenograft - natural bone; the donor and recipient are different species i.e. cow
Alloplast - synthetic; made in a lab


The scientific research has shown without a doubt that all of these materials can work in dentistry, and they all produce more or less the same clinical results. There are slight differences in the material properties for which a dentist may decide to use one instead of another. Talk to your dentist about which may be right for you, for instance if religious beliefs prohibit you from getting an allograft or xenograft.


Notice that grape seed extract is not on this list.

[Eugene80]

So is this timetable correct:
1) Extraction + bone graft: then wait ~6 months (eat mostly on one side)
2) Insertion of implant into the bone: then wait ~3 months (again eat mostly on one side)
3) Exposure of abutment to put a crown on the implant: yet another procedure where they drill into the gum, then again wait for it to heal

So in other words, the installation of an implant is something that takes close to a year, and it's a fairly traumatic year, too, in the sense that your chewing will be compromised for much of that year? That sounds like a very long process.