Post Operative Instructions for Cortical Onlay Bone Grafting
A certain amount of swelling, pain and bleeding is normal.
The following instructions are provided to make your postoperative recovery period as short and pleasant as possible.
You will be having a Cortical Bone Graft if the area that you are to have an implant placed currently has insufficient bone to place the implant. This procedure will augment the deficient area. The bone that is being grafted will most commonly be coming from your ramus or chin area. Other sites may be used as previously discussed with you by your doctor Because of this you will have two post-surgical wounds: the donor site and the recipient site.
- Bite down and maintain firm pressure on the gauze pack that was placed at the end of your surgery. There may be two areas of gauze in your mouth. Do this for at least 30 minutes. At that time remove the pack and replace it with another gauze sponge as provided. Repeat this as necessary. There should not be excessive bleeding. Bright red blood rapidly pooling in the area is not normal. If this occurs and does not decrease with pressure please call the office immediately.
- If you were asleep for the surgery be sure to eat a soft nutritious food prior to taking any medications. This will decrease the chances of post surgical nausea. You were prescribed a antibiotic prior to surgery this should be continued until all the pills have been taken. Take your pain medications as needed in accordance with the directions. Codeine, hydrocodone or Demerol can be supplemented with Advil or ibuprofen type medications. Be sure you have no allergies that the doctor does no know about.
- Do not rinse or spit for a minimum of 72 hours and longer if possible. This tends to disturb the blood clot, prolong bleeding, open the wound and slow healing. There should be no blood in your mouth. Saliva can be swallowed. Do not brush your teeth for 48 hours near the surgical site, only brush in areas away from your graft surgery. When expectorating, BE GENTLE. If you used a prescribed mouthwash prior to surgery, it should be continued starting 24 hours after your surgery. Place the mouthwash in the area of the surgery and let it sit 30-60 seconds. Do not rinse with it until after you have returned for suture removal.
- Apply ice immediately in the areas where the surgery was done. If your graft was in the anterior upper jaw you can expect swelling and discomfort up into the nose and even under the eyes. Bruising and discoloration is not unusual. Crushed ice or equivalent should be placed in a plastic bag then in a washcloth and placed on the face. Apply for 30 minutes, then off for 20-30 minutes. This should be done on a near continuous basis (or as much as possible) for the first 48 hours and longer if possible or if this helps reduce your pain.
- Avoid excess activity. In addition, DO NOT SMOKE. Do not drink with a straw or drink carbonated liquids (minimum 3 days). Do not consume alcoholic beverages while taking your pain medication.
- You will notice that you cannot see any new bone in your mouth as the gums covers the area. The area of the graft placement will feel full and tight. This is normal. Do not stretch your lip daily to inspect the area. This can cause wound breakdown
- If you have a temporary flipper to wear do not place it until the numbness in the area is gone. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. If you have questions about the fit of your flipper, do not wear it until our doctors or your referring dentist can see you.