Bone Replacement Graft for Ridge Preservation – Per Site - Dental Procedure Code Description

When a tooth is extracted from its place within the alveolar bone tissue that houses it, the tissue undergoes what is known as resorption, or a “breakdown” at the cellular level that takes its component materials and disperses them elsewhere throughout the body. In layman's terms, this bony material is essentially “taken” back “into” the body for other use.
 
This resorption of bone tissue causes a number of complications for future implants, prosthetics, and general aesthetics, because in resorbing the bone height recedes so much it can change facial features and prevent effective restorative dentistry. As a result, many dentists prefer to proactively stunt this resorption by using a bone graft. Bone grafts can be used immediately after an extraction or months or years after the loss of a tooth. This procedure is also commonly referred to as “socket preservation.”
 
There are four different types of bone graft that can be used at the time of the extraction, to preserve ridge integrity. They are: 

  • Autograft – Bone harvested from patient’s own body
  • Xenograft – Bone grafts or collagen from bovine or porcine origin
  • Allograft – Block bone graft from a cadaver
  • Alloplast – Synthetic biomaterials such as PLGA, hydroxyapatite, tricalcium phosphate, bioglass – ceramics, etc. 
Generally speaking, a bone graft is completed by layering one of the above materials into the pocket where the tooth used to exist. This is accomplished by first exposing the area by means of a surgical incision, and then by layering the material into the recessed area. A protective collagen membrane is then placed atop this material to aid in healing and stability, and then the area is sutured shut. When a bone graft is needed in the rear of the mouth and in the upper jaw, the procedure is more complicated because the sinus cavity is often involved. When bone loss occurs below the sinus cavity, the cavity tends to “drop” as a result. Thus, surgery in the area, requires specialized care so as not to disrupt this very delicate area.
 
To place a bone graft in this area, then, the sinus membrane needs to be elevated (or, lifted) out of harm’s way to allow for the addition of bone graft material. To accomplish this, an incision is made in the gum tissue to expose the bone, and a small oval-shaped hole is cut to expose the sinus cavity. Then, gently, and sometimes with a surgical balloon, the sinus membrane would be lifted out of the way to make room for the grafting material. Once again, a protective collagen membrane would be layered atop the graft, and the incision sutured shut.

There is a great variety to the type and procedure involved in bone grafts, and much is dependent on your dentist, your budget, the quality of the extraction performed, your overall health, your oral health, and the type of material to be used. Since preserving the ridge is critical to future restorative work and your cosmetic satisfaction, it is wise to consult with your dentist at length to determine the best procedure for you.

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