Understanding Bone Grafting & Bone Morphogenetic Protein

added on: December 28, 2015

Gingivitis is a relatively common form of gum disease that can turn serious without corrective dental treatment. When left untreated, gingivitis can continue to worsen and develop into advanced periodontal disease. This progression of gum disease causes extreme damage to your teeth, gums and jawbone tissue.

Tooth loss, especially when complicated by periodontal disease, causes your jawbone to deteriorate. To move forward with tooth and gum restoration techniques, you dentist first needs to restore the bone back to its original state. There are currently two choices available for dental bone restoration, bone grafting, and bone morphogenetic protein.

Mechanisms of Periodontal Bone Loss

Once gingivitis advances to periodontal disease, gum tissue starts to detach from your teeth. This detachment process leaves small open spaces, called periodontal pockets, which can extend deep beneath the gum line and leave the surrounding structures susceptible to bacterial infection.

As bacterial colonies enter the pockets, infection and decay begin to affect your teeth and gums. Your body responds by attacking the infectious material with white blood cells. Throughout this process, minerals in your jawbone slowly dissolve and pull away from your tooth. The demineralization of the bone weakens its structure and often leads to tooth loss.

Jawbone Restoration Required For Implants

If you lose teeth from advanced periodontal disease, the bone tissue in your jaw continues to deteriorate even further. This deterioration rapidly accelerates after the root of your tooth leaves the socket. If left untreated, the jawbone in that area will not have enough structural integrity left to accept an implant to replace the lost tooth. This will require you to have a procedure to rebuild and restore jawbone material before proceeding with the tooth replacement process.

After undergoing the selected bone restoration procedure, you must then complete the initial healing process before moving on to the implant placement step. Regeneration of the bone is required to accurately anchor the implant. Your jawbone will continue to heal and grow around the implant posts to permanently hold them in place.

Upon placing implants in the sections that are missing teeth, you may need to have your gums built up as well. Your dentist will consider the condition of your gums before suggesting the best procedure for your oral restoration needs. Restoration of the teeth and jawbone can help facilitate the growth of gum tissue.

Bone Grafting

Bone grafting is a surgical procedure that restores deteriorated jawbone to healthy levels. Targeted placement of organic replacement material encourages the growth of your own bone tissues over time.


Dentists have three main bone material options to use for this procedure including minerals from your bone tissue or those from a cadaver or cow. If you have enough healthy bone tissue in adjacent areas, your dentist may extract bone from one area and use it as filler in your open oral cavities. In situations where you do not have enough of your own bone material to use, dentists can use material collected from a cadaver or cow donor.


Your dentist will thoroughly clean the areas with the most missing bone tissue. Since the replacement bone will facilitate further growth, your dentist will only target areas in dire need of restoration. Upon filling the open cavity with the selected bone material, your dentist will close up the gap by stitching your gums back together.

Benefits and Risks

With proper aftercare, both at home and in the dental office, traditional surgical bone grafting procedures are a highly effective way to restore jawbone material. Quickly restoring the bone using prepared compounds can help reverse periodontal damage, which reduces the chance of adjacent tooth loss.

The biggest risk of any surgical procedure is the chance of an infection developing in the treated areas. Bacteria that cause infections can also accelerate tooth decay. As your gums start to heal, the previously open gaps could trap bacteria around the teeth, leading to the development of cavities at the roots.

Healing Time

Your body must overcome the initial swelling and bleeding caused by surgical trauma, which could take several days to a week. You can speed up initial healing times by using an ice pack to decrease swelling. Internal healing commences after the irritated tissues calm down. Full healing from this procedure often takes several months, though the use of medicated periodontal mouthwashes can decrease recovery time significantly.

Bone Morphogenetic Protein

Implantation of bone morphogenetic protein, recently approved by the Food and Drug Administration, is a new way to facilitate bone growth around the jaw. Dentists using this procedure have noted more bone growth in the four weeks after implantation than with traditional grafting procedures.


To facilitate bone growth, dentists apply the bone morphogenetic protein to a collagen sponge and place the material along the receded jawbone. The protein then directs the body to start restoring and calcifying the bone material.

Within a few months, your dentist will measure the bone growth and reassess the treatment plan. If necessary, it is possible to place a few more protein-soaked sponges in areas that are not seeing the proper amount of growth.

By the six-month mark, your jawbone should have enough material to anchor the required tooth implants in place. Dentists can also add the bone morphogenetic protein at the end of the implantation procedure to speed up the anchoring process.

Risks and Benefits

The risk of complications is decreased due to the relatively non-invasive nature of the bone morphogenetic protein procedure. Since your body produces its own bone material, the chance of rejection is eliminated. Patients often choose this option due to the low risk of complication coupled with quick healing times.

Drawbacks include the increased cost of having this new procedure performed and the six-month wait for the jawbone material to regenerate. As this is a relatively new treatment option, if your dentist does not currently offer the use of this protein, you may need to find an alternate clinic with experience and success using this procedure.

Healing Time

When compared with traditional bone grafting procedures, the protein application process is much less invasive. Swelling, bleeding and other complications associated with bone restoration procedures are significantly reduced with this new method. The newly formed bone tends to readily accept and grow around the implants due to increased blood flow to the tissues.

Seeking Care for Bone Loss

If you cannot seek prompt care for tooth loss caused by periodontal disease, you will likely require a bone restoration procedure to build up lost material. You can contact our doctors at The Oral Surgery Group to discuss bone restoration procedures, including traditional bone graft and bone morphogenetic protein procedures.

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