BONE GRAFT

Bone Graft

What is a bone graft?

In some cases, there is not enough height or width of bone to place an implant of an adequate size. This can be due to bone atrophy (from an area that has been edentulous for a long time) or the proximity to an important anatomical structure (sinuses, nerves, etc.). The exact bone volume is generally evaluated with a 3D radiograph which allows the surgeon to offer some treatment options. In the case of proximity to the sinus, the surgeon may suggest a sinus lift procedure along with a simultaneous bone graft before or during the placement of the dental implant. In other cases, patients with extensive bone loss may require additional or different types of grafting. Our experienced surgeons will detail the treatments available to you during your initial consultation visit!

Who needs a bone graft?

Patients who require implants but have insufficient bone may be considered candidates for bone grafting. Using state-of-the-art techniques, bone can be grafted to supply additional support for the implant.

Sinus Lift

The presence of the maxillary sinuses and bone loss due to; periodontal disease or post extraction atrophy often leads to situations where a patient does not have the required minimum bone height of 8-10 mm under the sinuses. This situation can be treated by the “sinus augmentation” or “sinus lift” procedure. This procedure is performed by pushing away the gums to expose the bone covering the sinus. A window is then created into the sinus, the sinus membrane is lifted, and bone is added to help create additional height for a dental implant. Depending on the material used, the graft is allowed to heal for 4 to 9 months prior to implant placement. Most patients experience moderate swelling and discomfort, which is adequately managed with mild analgesics such as ibuprofen or acetaminophen. The literature reports success rates ranging from 86-100%, depending on the graft material used. In our practice, we are achieving success rates of 93-95%.

We will be happy to explain bone graft and sinus lift procedures to you in detail, call us today for further information!

Instructions

Pre-Op Instructions

Pre-operative instructions with intravenous sedation

Intravenous sedation is a technique of administering medications through a vein to help relax you and reduce discomfort. This is done without putting you completely to sleep. It is most important that you follow the instructions below very closely.

  1. The meal before your appointment should consist of light food and fluids such as broth, tea, or Jello, and should be taken no less than 6 hours prior to your appointment. Do not eat meat, fried or fatty foods. You may drink clear fluids (water, fruit juices, carbonated beverages, clear tea, and black coffee) until 2 hours before your appointment.
  2. If you are given medication to take before your appointment, it should be taken with a small amount of water, one hour prior to the appointment.
  3. Do not take other medications on the day of surgery without checking with your surgeon. Let us know of any changes to your health status or your medications before your appointment.
  4. It is advisable to wear loose-fitting clothing to make you more comfortable. Short sleeve shirts or blouses are necessary, so we can see your arm for monitor placement and intravenous access.

After your appointment the medications used will still be in your system. The following precautions should be followed:

  • You MUST be accompanied home in a car or taxi by a responsible adult who will stay with you for the remainder of the day. No public transportation.
  • Change position slowly. Sudden standing or sitting up may cause dizziness.
  • No driving or operating machinery for the rest of the day after surgery.
  • No alcoholic beverages for 24 hours.
  • Rest at home with your head slightly elevated for the rest of the day.

If you follow these guidelines along with your surgeon’s post-operative instructions, you will find the procedure will go smoothly and comfortably.

Bone Graft: Post-Op Instructions

Post-op risks

The main risks are infections and bleeding. If you ever experience abnormal discomfort, contact us or the Oral and Maxillofacial Surgery residents of the Montreal General Hospital. Your surgeon will take charge of the situation.

A bruise, sometimes important, in the mouth, on the face and sometimes through the neck is quite normal.

 

Post-op instructions

Postoperative instructions will be provided following the intervention by the surgical assistant. You will normally leave with a prescription from your surgeon for painkillers and sometimes antibiotics.

The following instructions have been compiled to assist you in the post-operative period. If you follow these guidelines, your recovery will be more comfortable.

  • After a bone graft surgery, there is often swelling of the face and sometimes bruising of the skin. This is normal. An ice pack applied to the area (30 minutes on and 30 minutes off) for 48 hours will keep swelling to a minimum. Maximum swelling usually occurs within 24 – 48 hours after surgery. Swelling can persist for 7 to 10 days. If the swelling resolves but then returns, you should contact our office.
  • Eat a light diet for the first two days; e.g. yogurt, soup, jello, milk drinks, etc. and then progress to a more normal diet. Avoid hot foods and do not use straws for the first 48 hours after surgery, as this may cause bleeding.
  • Rest for the remainder of the day following your operation and keep your head slightly elevated.
  • Refrain from smoking for 2 months after a bone graft surgery.
  • Some bleeding is normal for the first 24 – 48 hours. If bleeding is heavy, use gauze squares folded in 4 and apply firm pressure to the bleeding area by biting on the gauze for 20 minutes. Do not spit for the first 72 hours following your surgery, as this tends to cause bleeding.
  • Gentle tooth brushing can be resumed the day after surgery. Do not brush the area of surgery until your next appointment with your surgeon.
  • You can start to brush your teeth the following day except where you had the bone graft surgery.
  • It is important to keep your mouth clean. Starting tomorrow, a saltwater rinse (1 teaspoon salt in 1 glass of warm water) should be used twice a day after eating (ex: after your breakfast and before going to bed).
  • You will be given a follow-up appointment to check the healing, if necessary.
  • Dissolving stitches are used for most operations. It is normal for these to begin to fall out after 3 – 4 days.

If you have any questions or problems, please call our office (514-486-1002) and we will be pleased to help you. Outside of business hours you can contact the oral surgery Resident on call at the Montreal General Hospital ((514) 934-8075 or (514) 934-1934 extension 53333). It is very important that you ask to speak to the oral surgery resident on call at the Montreal General Hospital.

Sinus Lift: Post-Op Instructions

Post-op risks

The main risks are infections and bleeding. If you ever experience abnormal discomfort, contact us or the Oral and Maxillofacial Surgery residents of the Montreal General Hospital. Your surgeon will take charge of the situation.

A bruise, sometimes important, in the mouth, on the face and sometimes through the neck is quite normal.

It is normal to find traces of blood from the nose on the pillow when waking. Bleeding may persist for a few days.

 

Post-op instructions

Postoperative instructions will be provided following the intervention by the surgical assistant. You will normally leave with a prescription from your surgeon for painkillers and sometimes antibiotics.

The following instructions have been compiled to assist you in the post-operative period. If you follow these guidelines, your recovery will be more comfortable.

  • After this surgical procedure, there is often swelling of the face and sometimes bruising of the skin. This is normal. An ice pack applied to the area (30 minutes on and 30 minutes off) for 48 hours will keep swelling to a minimum. Maximum swelling usually occurs within 24 – 48 hours after surgery. Swelling can persist for 7 to 10 days. If the swelling resolves but then returns, you should contact our office.
  • It is important to do not blow your nose for 3 days after the procedure.
  • Eat a light diet for the first two days; e.g. yogurt, soup, jello, milk drinks, etc. and then progress to a more normal diet. Avoid hot foods and do not use straws for the first 48 hours after surgery, as this may cause bleeding.
  • Rest for the remainder of the day following your operation and keep your head slightly elevated.
  • Refrain from smoking for 2 months after sinus lift procedure.
  • Some bleeding is normal for the first 24 – 48 hours. If bleeding is heavy, use gauze squares folded in 4 and apply firm pressure to the bleeding area by biting on the gauze for 20 minutes. Do not spit for the first 72 hours following your surgery, as this tends to cause bleeding.
  • Gentle tooth brushing can be resumed the day after surgery. Do not brush the area of surgery until your next appointment with your surgeon.
  • You can start to brush your teeth the following day except where you had the sinus lift surgery.
  • It is important to keep your mouth clean. Starting tomorrow, a saltwater rinse (1 teaspoon salt in 1 glass of warm water) should be used twice a day after eating (ex: after your breakfast and before going to bed).
  • If necessary, the doctor will have prescribed medication to be taken for relief of discomfort. The instructions for taking this medication will be on the bottle. Please follow them carefully.
  • You will be given a follow-up appointment to check the healing, if necessary.
  • Dissolving stitches are used for most operations. It is normal for these to begin to fall out after 3 – 4 days.

If you have any questions or problems, please call our office (514-486-1002) and we will be pleased to help you. Outside of business hours you can contact the oral surgery Resident on call at the Montreal General Hospital ((514) 934-8075 or (514) 934-1934 extension 53333). It is very important that you ask to speak to the oral surgery resident on call at the Montreal General Hospital.

MaxilloVendome Implantology & Surgery Clinic

Our oral surgery practice consists of Dr. Michel El-Hakim, Dr. Katrina Kontaxis, Dr. Dany Morais and Dr. Nicholas Makhoul.

2 Locations to better serve you

Montreal | Chateauguay