Have you lost teeth and would like treatment with implants? But your jawbone has broken down and you need a bone graft beforehand?
When is bone grafting necessary?
Bone grafting in the jaw is always necessary if you are to have dental implants and there is no longer enough jawbone to anchor an implant. There are fixed values that have been proven in many studies of the minimum thickness of the bone around an implant, so it does not break out.
How does bone loss occur?
Some amount of bone loss is quite normal and affects every adult patient. During life, the bone always breaks down a little. If one or more teeth are missing at a point in the jaw, the bone breaks down faster than normal because of the lack of natural stress there. In the first year after tooth loss, the breakdown proceeds faster, after that it is about 0.1 mm per year. Periodontitis also causes bone loss and tooth loss in some patients. Here the bone becomes inflamed and sometimes even retreats quickly. If dental implants are then to be inserted into the edentulous jaw, the bone must be built up accordingly.
What types of bone augmentation are there?
Possible methods of bone-building:
An internal or external sinus lift
If dental implants are to be placed in the upper jaw, they often perform a sinus lift. The name sinus lift comes from the maxillary sinus, which is called the sinus. The floor of the sinus is raised (lifted) and we introduce bone substitute material or bone chips from animal or own bones. A membrane ensures a good seal so that the new bone can heal. We can then place the implant on the patient. Internal means are created for the sinus lift via the oral cavity, external means that a minor operation through the cheek takes place from outside the mouth.
Bone deposition of chips or bone substitute material
The method is relatively easy to carry out and therefore also relatively cheap and not very unpleasant for the patient. Most often the dentist will perform the treatment while the dental implants are being placed. They introduce chips from the jawbone or bone substitute material into the bone. Then the dental implants are placed in the bone. They use this method in the upper and lower jaw.
Bone block
The procedure is also suitable for the lower and upper jaw. The patient’s bone material is taken in a block from another part of the body. They attach this material to the bone that is too thin and heals firmly after a while. The dental implants can only be inserted into the patient after this healing period.
Iliac crest graft
This somewhat more extensive procedure is used when a large area of bone is to be replaced to place dental implants. The patient is placed under general anesthesia and it removes the material from the iliac crest. They then insert it into the jawbone. The operation takes place in the hospital and is therefore the most expensive method. It is not performed by a dentist, but by an oral surgeon.
Bone splitting/spreading
With bone splitting or spreading, the self-healing powers of the bone are mobilized. The patient’s existing bone is split or pulled apart so it creates a small cavity. The bone cells are stimulated to grow and fill this space. As soon as the bone has grown back, the dentist can place the implant.
How are the bone grafting costs made up?
The costs for your bone structure are made up of various influencing factors:
- Fee for the dentist
- Outpatient or inpatient: possible costs for a hospital stay
- Used material
- The extent of the bone defect in the jawbone
- The effort of the method used
An exact statement about how expensive bone grafting will be for you is difficult to make due to the various factors. In principle, however, you can assume that the more complex the operation, the more expensive it will be.
Bone augmentation costs: how much does the treatment cost you?
Before treatment, your dentist will give you a treatment and cost plan that will give you an excellent overview of the likely costs. If you have already received such a plan, you can do a price comparison to see whether the costs are reasonable. Each method costs differently, and the amount of treatment also affects the total cost. Hence, it is difficult to say exactly how much it will cost to build the jawbone.
To still estimate the approximate costs, you will find here a list of the estimated total costs for the respective bone augmentation:
- Internal sinuses lift approx. €300-500
- External sinuses lift approx. €600-1100
- Bone deposition of chips or bone substitute material approx. 60-€350
- Bone block around €300-750
- Iliac crest graft approx. €5000 (including hospitalization)
- Bone splitting / spreading approx. €1000-1500
Does the health insurance cover the bone grafting costs?
The statutory health insurance does not cover any costs for the bone structure. As with your implant, you will have to pay for the treatment of the bone graft yourself. If you are privately insured, your contract determines which treatments the health insurance company will cover. Look at your policy or ask your insurer directly.
Only in exceedingly rare exceptional cases, for example, after an accident or cancer, does the health insurance company cover the costs of bone grafting.