Bone grafting procedure – is late implant rejection possible?

When is a bone transplant performed?

Bone grafting is necessary whenever the amount of bone tissue is insufficient for a stable implantation of the tooth. If the alveolar socket is deformed or its width or height is too small for the implant to integrate properly into the bone, bone reconstruction must be performed prior to implantation.

What Can Bone Defects Be Completed With?

Replenishment of bone defects and stimulation of regenerative processes is possible by three methods:

• Autogenic transplant — the use of the patient's own bone material, most often taken from the chin, the area of the molars, or the jaw tumor.
• Allogeneic transplant — bone material comes from a bone bank or from a donor; the method is less common due to the complexity of the process.
• Alloplastic transplant — the use of synthetic, bone-like materials such as hydroxyapatite or calcium beta-triphosphate.

How is the bone graft procedure performed?

The procedure consists of several stages:

1. Preparation of the site of the defect — after the administration of local anesthesia, the surgeon makes an incision to expose the bone at the site of the planned implantation.
2. Introduction of bone material — an autograft taken from the patient, a bone bank, or synthetic material is placed in the bone defect. In the case of an autograft, a block or bone chips are taken from the selected area of the body.
3. Covering the material with a barrier membrane protects the transplant site from the ingrowth of soft tissues, such as fibrous connective tissue, which promotes proper bone regeneration.
4. Wound closure and healing — the wound is sutured with stitches, and the process of forming new bone usually takes from 3 to 6 months, depending on the material used and the individual characteristics of the patient.

The procedure usually lasts from 1.5 to 3 hours and is performed under local anesthesia or sedation, which provides the patient with comfort and painlessness.

Is late implant rejection possible?

Dental implants have a very high efficiency; however, in about 1.5-2% of cases, their rejection by the body may occur. Implant rejection most often occurs within the first 3—6 months after implantation (so-called early rejection) and is associated with a lack of osseointegration, that is, the integration of the implant into the bone.

Late rejection, that is, moving the implant after a few years, is less common, but possible. The causes can be, among others:

• microtraumas of the implant caused by insufficient fixation in the bone;
• periodontal disease or infections around the implant;
• mechanical overloads;
• poor oral hygiene;
• systemic diseases or cigarette smoking.

What to do when the implant starts to move?

In the case of a moving implant, a quick consultation with a dentist or implantologist is necessary. The proceedings may include:

• diagnosis and treatment of infection (e.g., periimplant pocket cleaning, antibiotic therapy);
• removal of the rejected implant;
• carrying out a bone graft procedure to restore the bone base;
• re-implantation after a period of healing and bone regeneration.

Implantation failure does not mean a definitive lack of possibility of implant treatment. With proper preparation and application of restorative treatments, the chances of success are high.