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Is bone graft necessary after extraction?

User Level:
Patient
Posted by: OneUno  (2 years ago)
Hi!

I’m seeing an oral surgeon tomorrow to have my first molar on the lower right side extracted. I do not have any plan to get implant or bridge to replace it in the near future because of financial issue. I might as well just leave the gap there. The dentist said he would do a bone graft during the extraction regardless if I’ll get a replacement or not. I was just wondering if this is necessary. All I only wanted is for my tooth to be pulled because it was badly infected. Can I decline the bone graft? Please advise! Thanks.
User Level:
Student
Posted by: mdhola  (2 years ago)
I can understand your feelings about bone graft and potential cost associated with it. Bone graft is not always necessary assuming that it is normal extraction. However, i would like to clarify few things about placing bone graft just after the extraction:
- First of all bone graft helps you to preserve the height and width of the bone which is not only important for implant, but it also quite helpful even though you opt for bridge or removable denture in future. It can be placed at the time of extraction and it can be placed later on also.
- second, if by any chance in future you opt for implant and your dentist determines that you need bone graft at the site of implant placement, then you might need to go through additional surgery for the bone graft only and you also have to wait for more time to get the bone graft integrate well before implant placement.
- most of time it is easy and there is good prognosis to put bone graft in extracted socket (got all the walls around) rather than placing it afterwards over the bone and keep them in place with artificial membrane.

I would advise you to discuss all your future treatment plan with your oral surgeon and he/she will be able to give you more advise specific to your case.
User Level:
Dentist
Hi!

I’m seeing an oral surgeon tomorrow to have my first molar on the lower right side extracted. I do not have any plan to get implant or bridge to replace it in the near future because of financial issue. I might as well just leave the gap there. The dentist said he would do a bone graft during the extraction regardless if I’ll get a replacement or not. I was just wondering if this is necessary. All I only wanted is for my tooth to be pulled because it was badly infected. Can I decline the bone graft? Please advise! Thanks.


First of all, why the heck are you extracting a lower first molar tooth, unless it is impossible to save? Have you not considered a root canal?

A bone graft cannot be done in the presence of infection- they usually fail. The extraction has to be done, and the infection cleared. Only if there is no infection in the socket to begin with can a graft be done at the same appointment as the extraction.

Who knows what you will do in the future. Almost always, an implant and implant crown is the best way to replace a tooth. To do that, you will need enough bone. If you don't have enough bone, a sinus lift and graft is necessary, which is a whole lot more expensive and complicated than a bone graft after extraction.

Bottom line is a bone graft soon after the extraction will save you a lot of money later.

Kim Henry, DMD.
Posted 2 years ago
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