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Dentistry/bone grafting

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QUESTION: Dear Doctor,

I have a baby tooth that has developed significant decay in the jaw bone making an implant impossible without bone grafting.  I am trying to find out if there is any controversy re: using cadaver bone to stimulate re-growth.  I am 55 years old and the baby tooth is solid but there is a large gap in the gum line and it has a small infection.

Also do you have a sense of what the going rate is for this type of procedure/

Thank you very much.
Therese Bimka

ANSWER: Therese - I cannot determine if a bone graft is actually needed after the extraction, but since there seems to be an infection already present, once the tooth is extracted, no bone graft should be placed until the infection is completely gone.  If placed immediately after the extraction and any infected existing in the area, the graft has a smaller chance of healing properly. So if there is bone loss in the area or if bone needs to be removed to extract the tooth, then a graft might be appropriate.  So if a graft needs placement and there is any infection present, no graft can be placed until the infection is completely healed.  

The fee is variable and varies in different areas of the country.  The fee could be anywhere from $250-1000.  Most important is the skills of the doctor doing the extraction and the graft.  It should only be a skilled surgeon and not a general dentist.  

---------- FOLLOW-UP ----------

QUESTION: Thank you for your response.  I was interested in any information that is controversial regarding cadaver bone grafting other than moral objections.

Thank you very much,
Therese

Answer
Therese - Cadaver bone is a good replacement for a bony defect.  It is advisable in certain situations and I prefer synthetic graft in some situations.  In certain locations, the healing of the bone with cadaver creates a more dense bone.  That is important in areas of the body that sustain more stress.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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