Full bone remodelling takes months, and no amount of willpower on the patient’s part can speed it up. What you can do, however, is something else: avoid slowing it down and avoid a complication that would add further weeks to the whole process.
This article describes what happens in the tissues, step by step, and which aftercare instructions apply in the first few days after the procedure. It is followed by a list of things to avoid and the symptoms that call for contacting the surgeon.
What is bone grafting and what does the procedure involve?
Bone grafting is a procedure to rebuild bone tissue in the upper or lower jaw. It is performed in the bone of the upper or lower jaw when the height or width of the ridge does not allow an implant to be placed securely.
Rebuilding the jawbone is therefore often a preparation for dental implant placement rather than a separate treatment. The aim is to fill in the bone where it is missing so that the conditions for a stable implant are created.
It is a surgical procedure carried out under local anaesthetic. Under local anaesthetic it usually takes between 30 minutes and 2 hours, depending on the extent of the procedure. Bone grafting is not funded by the Polish National Health Fund (NFZ).
| What | Cost |
|---|---|
| Closed sinus lift | 2000 PLN |
| Cost of bone grafting in Poland | from 1500 PLN |
| Minor bone graft | from 1500 to 3500 PLN |
| Cost of a CBCT scan | from 150 to 300 PLN |
Bone grafting in the upper and lower jaw: available methods
The term covers several different procedures, and the choice depends on the shape and size of the bone defect.
- A graft of the patient’s own bone, most often taken from an area next to the treatment site.
- Bone blocks fixed with screws for large vertical defects.
- Guided bone regeneration, in which the bone material is covered with a membrane.
- Filling the defect with a biomaterial, that is, granules placed where bone is missing.
Autogenous grafts, that is, grafts of the patient’s own bone, are preferred in bone grafting. They contain living cells and integrate with the patient’s natural bone better than foreign materials. Synthetic and animal-derived materials act as scaffolding along which the patient’s own bone grows into the defect.
Materials and membranes in jawbone grafting
The membrane acts as a barrier that prevents soft tissue from growing into the space intended for bone. The gum regenerates faster than bone, so without this barrier it would fill the defect before enough new bone tissue had time to form.
The type of material used affects healing time. With slowly resorbing materials, remodelling takes longer, but the gain in volume is more durable, which matters in the aesthetic zone.
Maxillary sinus floor elevation
In the back of the upper jaw, the obstacle to an implant is often not so much a lack of bone as the position of the sinus. Sinus floor elevation then involves lifting the sinus membrane and filling the resulting space with bone material.
The closed method is less invasive and is performed through the tooth socket. The open method requires access from the cheek side and is used when the bone height deficit is greater.
After this procedure additional restrictions apply, which I describe below. They arise because any sudden rise in pressure in the sinus threatens the freshly lifted membrane.
How long does healing take after bone grafting?
The process takes place in two stages, and these two stages differ greatly in length.
Soft tissue healing
The critical period of soft tissue healing lasts 24 to 72 hours, while the blood clot forms and the wound closes. Soft tissue healing usually takes 7 to 14 days, and the stitches are usually removed after this time.
Swelling after bone grafting peaks between the second and third day, then gradually subsides. Slight bleeding from the wound in the first few hours and bruising of the cheek are natural reactions of the body, not a sign of a complication.
Rebuilding bone before dental implant placement
Full bone regeneration can take from 3 to 9 months, although some sources give a range of 4 to 9 months. Healing time can vary from patient to patient, because it depends on the extent of the procedure and on the patient’s individual circumstances and predispositions.
In practice, after an extraction that requires bone regeneration, we usually plan implant placement after about four months. Loading immature tissue earlier risks losing the volume that has been gained.
Several things affect the pace of the process at the same time.
- the patient’s general health and age, because the pace of regeneration depends on general health,
- the type of material used and the surgical technique,
- the size of the bone defect and the extent of the procedure,
- oral hygiene during the healing period,
- smoking, which impairs blood supply to the tissues after bone grafting.
Aftercare following bone grafting: the first 48 hours
Rest for the first 24 to 48 hours is crucial after bone grafting, because this is when the blood clot forms. Strictly following the post-operative instructions and your dentist’s advice during this period has a greater impact on the outcome than anything later on. Following the aftercare instructions helps minimise the risk of complications.
- Applying cold compresses in cycles of about fifteen minutes of cooling followed by a break; cold compresses will help control swelling after the procedure.
- Taking medication as instructed by the dentist or surgeon, avoiding products containing acetylsalicylic acid (aspirin), which increase bleeding.
- Sleeping with your head raised, which limits swelling.
- Not drinking through a straw, because the suction can damage the blood clot.
- Not touching the operated area with your fingers or tongue.
Cold compresses bring the most benefit in exactly these two days. After that, the swelling starts to subside on its own and cooling no longer serves a purpose.
Oral hygiene after the procedure
Careful oral hygiene is important after bone grafting, but restrictions apply in the first few days. For the first 24 hours, do not brush your teeth near the wound and do not rinse your mouth vigorously.
After 24 hours you can start gently rinsing your mouth with the antiseptic mouthwash recommended by your dentist, letting the liquid flow around without vigorous movements. Gently brushing the other teeth with a soft toothbrush continues from the start, avoiding the operated area.
Proper care after bone grafting is crucial to the success of the graft, because wound infection is often the most common cause of losing the volume gained. That is why good oral hygiene is maintained throughout the healing period.
Diet in the first few days
For the first few days, eat only soft or liquid meals at room temperature. Do not have hot drinks or hot food after bone grafting, because heat increases swelling and bleeding.
- allowed: yoghurts, cream soups at room temperature, purées, seedless fruit mousses, smoothies,
- to avoid: hard, crunchy, sticky, spicy and acidic foods,
- no foods with small particles that could get into the wound.
Avoid hard and crunchy foods for the first few weeks, not just the first few days. It is also worth making sure you get nutrients that support bone regeneration: calcium, vitamins D3 and K2, vitamin C and zinc.
What to avoid before and after bone grafting
A few habits genuinely prolong healing and increase the risk of complications. Cutting them out has a stronger effect than any supplement.
- Smoking: avoid it for at least two weeks or so after the procedure, and preferably longer. Nicotine constricts the blood vessels and limits the oxygen supply to the wound.
- Alcohol: it is not advisable in the first weeks of healing and interacts with medication.
- Exertion: avoid strenuous exercise for 7 to 10 days after the procedure, and longer after extensive procedures. Avoiding intense physical exertion reduces the risk of bleeding and haematoma.
After a sinus floor elevation there are further restrictions. You must not blow your nose hard, sneeze with your mouth closed, dive or, for a period of time, fly. Each of these activities causes a sudden change in pressure in the sinus.
Possible complications and worrying symptoms
Bleeding and swelling are natural reactions after bone grafting, but how they develop matters more here than the fact that they occur. Normal symptoms ease; complications get worse.
- infections, which are one of the most common complications of bone grafting,
- rejection of the graft material, a serious complication that ends in the loss of the reconstruction,
- inflammation of the bone at the treatment site,
- sinusitis after sinus floor elevation,
- the wound opening up and the membrane becoming exposed.
Contact your dentist if the pain gets worse after the third day instead of easing. Fever, pus from the wound or nose, bad breath and swelling that is hard and hot to the touch should also be a cause for concern. Ignoring these signs prolongs treatment and increases the risk of losing the bone material.
Regular follow-up visits make it possible to assess healing and remove the stitches. Attend the scheduled follow-up visits after the procedure even if nothing hurts, because some problems develop without symptoms.
Contraindications to the procedure
Assessing your suitability covers your general health, not just local conditions. Factors that impair healing are contraindications to bone grafting, although some of them are temporary.
- active cancer, which is an absolute contraindication to the procedure,
- uncontrolled diabetes, which is a contraindication to bone grafting,
- blood clotting disorders,
- autoimmune diseases during a flare-up,
- advanced periodontal disease requiring treatment first,
- uncontrolled systemic diseases, which may make bone grafting impossible,
- smoking, which increases the risk of bone graft failure.
The assessment is based on your medical history and a CT scan, which we carry out with a NewTom Giano HR scanner. The three-dimensional image shows the height and width of the bone and the position of the sinus and the nerve, and on this basis the procedure is planned in CoDiagnostiX software.
How much does bone grafting cost?
In the Flow Dental Studio price list, bone grafting (regeneration) starts at 2500 PLN. Closed sinus floor elevation costs 2000 PLN, 5000 PLN with bone condensation, and the open method costs 6000 PLN.
Across the market, the cost of bone grafting in Poland ranges from 1500 PLN to 8000 PLN. A minor bone graft costs from 1500 to 3500 PLN, and a major one from 4000 to 8000 PLN. A CBCT scan costs from 150 to 300 PLN.
The final amount depends on the type of material used, the size of the bone defect and whether a membrane is needed. We give you a quote after diagnostics, together with a plan that covers the subsequent implant treatment.
Bone grafting and dental implant planning
Rebuilding bone is not an end in itself. It is meant to allow implants to be placed later in the position dictated by the prosthetic plan, rather than wherever a little bone happens to be left.
That is why we plan the bone grafting procedure together with the whole implant treatment, based on the same CBCT image. The implant treatment plan is therefore ready before the first incision. Digital planning and a surgical guide make it possible to limit the size of the incision, and less surgical trauma means less swelling and faster healing.
In some cases bone grafting is performed at the same time as implant placement, when the defect is small and primary stability is sufficient. The decision is made separately for each patient. With larger defects the procedures are spread out over time to give the bone a chance to mature.
What really speeds up healing?
There is no way to shortcut biology. Bone remodels at its own pace, and no product will change that.
What you can do is remove everything that slows down healing: tobacco smoke, neglected hygiene, putting strain on the wound, hot food in the first few days and ignoring symptoms. That is the only way to speed up the healing process. Proper care after bone grafting affects the success of treatment more than the choice of biomaterial itself.
