I lost four of my front teeth as a child on a bicycle. At 50, instead of replacing them another bridge, I chose dental implants. The dentist said he had to do a bone graft. I knew that beforehand. My Implants failed. No bone around the Implants. I was told by my dentist that he used freeze dried bone for the graft to promote bone growth. Now he says that this time around he will use cadaver bone for the graft. I have done some research and read that the freeze dried bone is not useful with implants. Am I right? Is using cadaver bone the better choice? Any advice?
Before getting to your question about the types of bone grafts available, it is important to consider your case. The area where you need to have implants placed is one that requires a lot of skill, knowledge and understanding of soft tissue and bone biology for you and your dentist to have a successful outcome in any grafting and implant procedure performed.
If you lost your teeth at an early age and now at age 50 you want implants, you can be sure that the bone in the area where the implants need to be placed is deficient, both in height, and in width.
For you to have safe, and predictable implants placed in that area you need 12 millimeters of bone height and 6 millimeters of bone width.
A conebeam CT scan that takes 15 minutes and is equivalent to a panoramic x-ray in exposure. It will tell you exactly how much bone you have, and you can plan the grafting procedure that you need in detail, in advance, before any surgery is done.
Freeze dried bone describes the method used to process the bone, not the source, and there is freeze dried bone available that comes from cadavers.
The question you should be asking is whether the quantity of bone required in your particular case can be accomplished by particulate bone grafts like the ones your dentist is suggesting, or whether you need to have a block graft to obtain the necessary bone volume to place the implants.
If you need more than 2 or 3 millimeters in width and/or if an increase in height is also necessary, then you need a block graft. These can be obtained from a cadaver or from your own jawbone (which requires a second surgical site) but is the gold standard for such grafts.
Don't be afraid to ask your dentist about his experience and success with grafting cases such as yours and ask to see pictures. Most expert implant surgeons document their cases well.
If you are still in doubt about the treatment being proposed to you, obtain a second opinion from an implant dentist.
I am sorry that you have not had success so far, but I think you are on the right track by starting to ask questions and inform yourself about your options.
Carlos Boudet, DDS, DICOI