Is my bone graft failing?

Question

I've had a permanent bridge running between my eye teeth for 17 years and it was failing. 5 weeks ago I had it removed, my eye teeth were extracted, two implants were placed and some bone grafting was performed. I've been wearing a temporary denture to fill the space. Everything has healed up quite nicely, until today, I just noticed that there seems to be some hard white material poking through my gum and I don't know if this means that my bone graft is failing. There is no pain or discomfort.

Steven Davidowitz, DDS · Answer

Exposed bone in mouth after A graft is many times normal. You may be worried because you can see that the bone is exposed inside your mouth. You may also be worried because small, hard granules, pieces, or particles of bone coming out of the socket. You may see white bone showing.

DON’T PANIC! But do have the area looked at by the dentist who placed it.

Socket bone grafting is very common and is encouraged when the outer wall of bone is very thin. The goal is to prevent the bone from shrinking and preserve the bone mass.

Most socket bone grafts have particulated bone added to the socket and are covered with some type of membrane at the same time of the surgery. The bone may be from your own body, from a human cadaver, from a cow or synthetic bone.

Ideally over the course of the first week, the gum heals over the top and no bone is showing at all. It is not uncommon for some bone to become exposed during the process of healing. It is also not uncommon to have some of these granules come out during the healing process.  antibiotic is commonly prescribed during most socket bone graft procedures as this will help reduce the chance of infection.

As long as you are not infected then it should not be a problem. Signs of infection would be redness, pus, pain and in some cases fever.

Bottom line…some exposure of bone and bone graft migrating pieces is common, but it is preferred that all of that stays in the socket. It does not mean the graft has failed. But have it checked out.

Jonathan Waasdorp, DMD, MS · Answer

Often times when grafting is done some of the bone particles (especially if the site was "overfilled") work their way through the incision or can be visible through thin tissue.  This is a normal part of the healing process and is most likely what is occurring. However you should follow up with your dentist as soon as possible so this can be confirmed clinically.

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