Bone Grafts

What is a hip graft?

One of the easiest ways of filling in a hole in a jaw bone is to use bone from the hip. A “hip graft” involves collecting bone from the pelvis above the hip joint. You can usually feel the area of bone that will be used since it forms a bony lump some 6 inches (20cm) above and in front of the hip joint.

What does the surgery involve?

A cut will be made through the skin immediately overlying the bone that will be removed. The length of the cut obviously depends on how much bone your surgeon needs. If he only requires a small amount of bone (eg to graft a cleft site) the incision may only be a couple of inches long.

What will the area be like once the bone has been removed?

At the end of the operation the incision will be carefully stitched together. Depending on the amount of bone that is removed a small plastic tube (“drain”) may be placed into the wound. This tube is connected to a bottle and allows any tissue fluid or blood to drain out of the wound. The drain usually stays in place for a day or so. If a large amount of bone has been removed your surgeon may put a second plastic tube into the wound before it is closed. Through this tube local anaesthetic can be administered. This local anaesthetic will keep the area numb and help reduce any pain.

What can I expect after the operation?

The hip tends to be sore for at least a few days even if only a small amount of bone has been collected. If large amounts of bone have been removed the area may be sore for a couple of weeks. Because the area around the hip is sore you may have some problems walking. Rarely you might need to use a walking stick for a few weeks after the operation.

How long will I be in hospital?

Your length of stay depends not only on your hip graft but also on the other procedures that you have had carried out at the same time. But you should expect a couple of days in hospital.

Do I need to do anything when I get home?

A dressing will have been put over the hip wound after surgery. You need to keep the area dry until this dressing and the underlying stitches have been removed. You should remember that you cannot drive or operate machinery for 48 hours after a general anaesthetic. If you find walking difficult when you get home you may also not be able to drive for a while because it is only safe to do so when you can safely perform an emergency stop in your vehicle.

Implant Surgery: What is an implant?

An implant is a false metal root screwed into the jawbone. Implants form anchors for a crown, bridge or denture attachments.

What does implant surgery involve?

Implants are usually inserted under local anaesthesia (ie an injection to make the area numb). Once the local anaesthetic injection has worked the gum is cut and pushed back to expose the underlying bone. A hole is then drilled into the bone and the implant screwed into this hole. The gum is then put back in the right place with stitches. These stitches are usually dissolvable but may take several weeks to disappear.

How long will the operation take?

It usually takes around half an hour to place a single implant. Obviously if you are having more than one implant placed it will take longer.

What can I expect after the operation?

It is unlikely to be very sore after implant surgery but regular painkillers (eg Ibuprofen) will be arranged for you. There is relatively little in the way of swelling.

Do I need any time off work?

It is advisable to take the rest of the day off work. You may also need to stay at home for a day or so depending on the type of job you have. If lots of implants have been placed and this has required intravenous sedation or a general anaesthetic then it is important to remember that you cannot drive or operate machinery for 24 hours after intravenous sedation and for 48 hours after general anaesthesia.

Is there anything that I need to do when I get home?

It is important to keep the surgical site as clean as possible for the first few weeks after the implants are inserted. It may be difficult to clean around the area because it is sore and if this is the case it is best to keep the area free from food debris by gently rinsing with a mouthwash or warm salt water (dissolve a flat teaspoon of kitchen salt in a cup of warm water) commencing on the day after surgery. You will have been prescribed a course of antibiotics to reduce the chances of infection. Please remember to take these.

What are the possible problems?

Although there may be a little bleeding at the time of surgery this usually stops very quickly and is unlikely to be a problem. Should the area bleed again when you get home this can usually be stopped by applying pressure for at least 10 minutes with a rolled up handkerchief or swab.

Infection is uncommon particularly if antibiotics are used.

If you are having an implant placed into your lower jaw it is important to be aware that some nerves may lie close to the site of surgery. One of these runs through the centre of the jawbone and supplies feeling to your lower lip, chin and lower teeth. The other runs on the inside of the lower jaw and supplies feeling to your tongue and helps with taste. Sometimes these nerves may be bruised when an implant is placed. This can cause tingling or numbness in your lip, chin or tongue, and more rarely altered taste. The chances of these nerves being bruised depends on exactly where your implant is going to be placed and how much bone there is around the nerves. Your surgeon will tell you what the risk is for you.