Guided Bone Regeneration

The most basic form of bone grafting

Bone grafting to add bone volume

gbrAt Skin & Smiles over 60% of our implant cases require some type of bone grafting. We have a success rate of over 98% in this procedure and so if you require this type of grafting you will be in good hands.

A common abbreviation for this process is GBR.

There are numerous materials that are currently available for increasing bone. We will inform you about the alternative treatment methods and the materials that are available. We only use a synthetic graft material.

 There is, of course, the option of using your own bone in the graft procedure. This tends to require more than one surgical site and has its own pros and cons. We will discuss this with you.

If you do not have enough of your own bone available for us to be able to stabilise a tooth or to securely anchor a dental implant, GBR will be used to increase your own bone, thus providing us with an adequate amount for the procedure you require. Graft materials act a solid scaffold which serve as a guide-rail to allow new bone to grow.

This scaffolding material enables and facilitates bone formation in the area where the operation is performed. It is inserted into the operation area in the form of grains or small blocks. Your own bone slowly grows into the graft material, which at a later time is gradually broken down by the body.

Synthetic Bone Grafting

At Skin & Smiles all of our grafting is done with a fully synthetic bone-like particulate materials. Bone regeneration is supported by this material composition, similar structure to bone and the resulting resorption characteristics.

The particulate is placed into the void either beside/against an implant or into a void to preserve the natural shape of bone. It is then wrapped with a collagen membrane (see below). Healing will take between 3-4 months in most people but longer in those that may have medical conditions such as diabetes and osteoporosis.

Bone grafting of any sort is negatively affected by smoking as this reduces the blood flow to the oral tissues. We will advise you to stop smoking for at least 4 days before and 4 days after surgery if you will be having any sort of grafting. If you continue to smoke after this period and the graft is not successful then subsequent procedures may not be possible or be adversely affected.

We recommend the use of high dose Calcium supplements to aid the body during healing when you have had a graft. These are readily available from High Street stores such as Holland & Barrett. Calcium metabolism requires the presence of Vitamin D and so we recommend a combined supplement.

Your own (Autogenous) Bone

We can use the body’s own bone, which is taken from a different location, for example the local area to the primary surgical site, the chin or back of the lower jaw. However this procedure requires additional anaesthesia. Once the bone is harvested from its original site it is then inserted into the operation area. In this procedure, the following must be considered:

  • There is now a second area of operation, which may be associated with additional pain or loss of sensitivity.
  • It is possible that the amount of the newly gathered bone will not be adequate for the intended purposes.

Collagen Membrane

A membrane made of collagen is generally used to cover the bone replacement material. It has been proven that better healing rates are achieved when the bone particles are covered with a membrane because the tissues of the gum grow more rapidly than the new bone and the membrane protects the particles from this faster growing connective tissue. This ensures that the underlying bone can heal in an undisturbed fashion.

The membranes are composed of highly purified natural collagen obtained from pigs. The collagen membrane becomes completely broken down by the body, hence a further operation to remove it is unnecessary.

Last Updated on 01/06/24 by Webmaster


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Stephanie K
Stephanie K
12 April 2022
Every visit to this clinic has been a pleasure, not something one would normally hear about the dentists, but I wanted to share my experience at Skin and Smiles, I almost look forward to the next visit. I took advantage of a first free consultation in which my options were outlined, and led onto several others for investigation, 3D scanning, Xrays, and discussions about what I wanted to achieve. Dr Murgai is honest in what can be achieved, is most detailed in his explanations of treatment and costs. His range of high-tech equipment is outstanding and it complements his professional skill and personable manner, along with his in-depth knowledge and consummate expertise has ensured each visit has been most beneficial. He explained each step of the process and allowed me several options with a full financial breakdown of costs and the honest expectation of the desired outcome. There was no pressure to chose the any particular options, the possibilities of what could be achieved and at what price was my choice and I’m so very pleased with the work. The team at this clinic are pleasant, professional and most importantly are friendly yet efficient; nothing is too much trouble. I always feel confident in their capacity to put me at my ease. The practice manager phones a couple of days after major works to enquire how I feel and I know that if there was a problem, their 24-hour support line is there if needed. I know they would accommodate me at very short notice, later the same day if needed. The team which surrounds Dr Murgai are wonderful, his practice manager, his dental nurses, his hygienist, and his laboratory technicians are superb and experts in their particular dental field. My teeth/gums have deteriorated over the years and whilst I’ve had treatment by other dentists over the years, it was time to seriously assess my long-term prospects. Dr Murgai took a holistic approach of my mouth, and we discussed the options available. This was reassuring and I didn’t feel as though I was just another customer. The different costs of alternative treatments were thoroughly explained in a treatment plan and I was given the choice of which of the packages I wanted. I’ve felt safe and reassured in every way since my first free consultation to my very soon to be completed transformation. I had contemplated going abroad for implants as the cost was less, I can emphatically state that having a local professional expert clinic was been the best option for me. I am so pleased I chose Skin and Smiles for my work; it’s been worth the investment. They are dedicated professionals and worthy of my utmost praise and recommendation.
Marian Moldovan
Marian Moldovan
8 February 2022
They have done a very good job, even though they have pulled my tooth out! A team that makes you feel comfortable and relaxed. Great job Skin & Smile 👏
Tony Dolente
Tony Dolente
15 December 2021
After searching for a while to find a decent dentist I found skin and smiles just by reading the reviews I knew I would be in safe hands ..and I was right , I had 4 very loose bottom teeth and I opted for implants , it was a very long journey for me as I started in February and only recently finished but it was well worth it, Dr Gulshan and all the staff were very professional and friendly from start to finish , and I will be continuing to use there service from now on , keep up the good work ... and thank you for all you done .. Wishing you all a very happy Xmas and a happy new year ... 🙂
Helen Hopping
Helen Hopping
2 August 2021
I went to skin and smiles as I had previously been unhappy with 2 other dentists and I was aware that I could be in danger of losing another tooth. I wanted one place to go to get everything sorted and not to have to look for a specialist for crowns, implants etc Very professional service and I was immediately made to feel at ease and I knew I had made the right choice I had to have a crown on a tooth that was cracked and this was all sorted within the same appointment, very impressive I also needed an implant and whilst this took several months from start to finish, I knew I was in good hands. I had a little discomfort which dissipated after a few days I am so pleased with how my teeth look and would definitely recommend them
Gembiczki Enikő
Gembiczki Enikő
5 July 2021
The best dental surgery in Watford and around I am more than happy to start my treatment with S&S. It was a long journey, but you made my treatment so relaxing. More than happy to go back any time. Friendly environment and kind people ready to help you.🤗 A big thank you to the team 🙏🏽
Kristina Taylor
Kristina Taylor
30 October 2020
I recently completed the process of a tooth implant which was rather lengthly as it also involved an extraction and bone graft. I cant recommend Dr Murgai and his team highly enough. Professional dentistry at its best. Thank you I am thrilled with the results Kind regards Kristina Taylor
Graham Smith
Graham Smith
21 October 2020
Just a few words to say thanks to Dr Murgai and all the team at Skin and Smiles post my treatment for a dental implant. Firstly I would like to echo the reviews from those who have reservations regarding dental treatment. As someone who is anxious with dental care I can say that my treatment was first class. I was completely put at ease by their care, communication and professionalism. In my case the treatment was complex, including an extraction, yet was carried out without causing me any discomfort or worry and I am extremely pleased with the quality of the work Dr Murgai has undertaken. Their surgery is modern and well equipped while the interior is well lit and comfortable. It really does put you at ease from the start. It is also within easy walking distance of Watford tube station. I thoroughly recommend this practice and would have no hesitation in returning in future should I require similar treatment.

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