Oral Surgery/Bone Graft Particles
QUESTION: I had a bone graft done 6 weeks ago. Sutures and membrane have since been removed. When I gently place my tongue over the area, I can feel particles sticking out from the gum. I've read that some can come loose and have, and I have felt maybe 10 in my mouth (total) at various times. I just wonder if it's okay for the bone particles to be sticking out of the gum area.
Also, because of a poorly fitting temp crown (#13) next to the bone graft area (#14-15), my tongue tends to go between 12 and 13 (possibily even sucking). Will this adversely affect the bone graft healing?
ANSWER: Chris - At six weeks after placement of the graft material, it is not uncommon for particles to be loose and not attached. It takes a minimum of 4-6 months for those particles to actually come together and help form bone. When a membrane is removed early and does not naturally breakdown, that can also allow some particles to be loose and not part of the future bone area.
That poorly fitting crown could adversely affect the graft if the tongue places too much force in the area. The dentist should remake or adjust the crown to fit properly or the recurrent tongue action could affect the graft.
---------- FOLLOW-UP ----------
QUESTION: Dr Teig, thank you for all that information. It seems my oral surgeon prefers to keep me in the dark, so your answer is very enlightening. I guess the waiting to repalce the temp crown is because a new impression will be taken for the new temp crown for #13. How long is the proper waiting period before an impression can be taken as some of the goop material used will have to go over the bone graft area?
So is the loss of small particles mean the graft is not going to be as good as it could have been? I understand that the loose particles is common but is it bad?
Chris - Especially since it has been six weeks since the graft was placed, there is no reason that a new temporary crown cannot be made - impression or not.
The loss of some particles will have no effect, as long as the bulk has not been disturbed. Loose particles are not uncommon during the healing phase. Obviously less is better than more for the loss of particles, but some should not be a problem, if the doctor who placed the graft material did it properly.