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Medical Forum / General / Dentistry / October 2005Question about bone graft materials and prices
As in my thread above I mentioned that I may be getting a bone graft at the time my tooth #18 is extracted, next week, for possible future implants. I am confused about grafting. My friend had a couple of grafts recently and told me it cost him $4000. Not sure how they were done, I just know the cost. My oral surgeon, on the other hand, told me that doing a graft at the time of my extraction would run only about $400 extra on top of the $10 Delta price for the extraction. Why the giant difference in price of a graft (my friend's $4000 vs. my $400)? Am I getting some kind of bargain basement graft that is not as good, or ... what is the deal? Why the huge price difference? I read that some grafts are taken from the patient's jaw or hip, and others use artificial bone or demineralized bone from some other source. What determines what type of graft material is used, and is that the main difference in price? Maybe someone could refer me to a website with explanations of this stuff in layman's terms? (Yes, I know about google; I just thought someone here might know of a GOOD site as opposed to my having to guess which one is good and looking at 20 to find a good one...) > As in my thread above I mentioned that I may be getting a bone graft > at the time my tooth #18 is extracted, next week, for possible future [quoted text clipped - 23 lines] > someone here might know of a GOOD site as opposed to my having to > guess which one is good and looking at 20 to find a good one...) The price disparity can be anything. You should know that what is referred to as a "bone graft" can be anything from a jaw reconstruction after cancer surgery to slipping a little powder into the extraction site. Your graft will likely be more like the second--perhaps with a membrane sutured in to cover and protect the area. If someone wishes to have multiple implants on an atrophic lower jaw, it could indeed require much bone, second (donor) graft sites, and even a hospital stay. The difference is probably more to do with the extensiveness of the graft done. Some surgeons I've heard are grafting just about any extraction that is being considered for an implant. If they're just pouring a little powder in there and stitching, $400 might be very high. (I should point out that I do NOT know the cost of some of these graft materials. They're probably expensive, but still...). If you are getting a mandibular resection with a titanium mesh and bone harvested from your iliac crest in the hospital, the cost is going to be way more than $4000, and if it is done well it is still a bargain. Yours is also less likely to have any complications. If you have any concerns, I'd advise you to get a second opinion. IMO, it you think you can do the implant within about a year, having the socket grafted is probably good insurance. Steve  Signature{\rtf1\ansi\ansicpg1252\deff0\deflang1033{\fonttbl{\f0\fswiss\fcharset0 Arial;}} {\*\generator Msftedit 5.41.15.1507;}\viewkind4\uc1\pard\f0\fs20 Remove "nospam" to reply\par } Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is probably just sticking some powder in there and stitching.... but I really don't have time to go get a 2nd opinion. If this guy is good at what he does - and he supposedly teaches at UCLA dental school, so I assume he knows his stuff - then I guess I'll just let him overcharge me if that's the case, and hope he at least does a good job. Then again, maybe it's not an overcharge; I don't know. And as for his teaching at UCLA, I guess being a good dentistry teacher does not necessarily make you a good dentist or oral surgeon! What is that saying, "Those who can, do; those who can't, teach"? I hope he is one who can, and also teaches! Thanks for the explanation! >Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is >probably just sticking some powder in there and stitching.... but I You are learning ...... >really don't have time to go get a 2nd opinion. Then you pay! >If this guy is good at >what he does - and he supposedly teaches at UCLA dental school, so I >assume he knows his stuff - then I guess I'll just let him overcharge >me if that's the case, and hope he at least does a good job. Then >again, maybe it's not an overcharge; I don't know. Where can we find more patients like you? This sounds easier than what I do for a living. >And as for his teaching at UCLA, I guess being a good dentistry teacher >does not necessarily make you a good dentist or oral surgeon! What is >that saying, "Those who can, do; those who can't, teach"? I hope he is >one who can, and also teaches! > >Thanks for the explanation! >>Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is >>probably just sticking some powder in there and stitching.... but I [quoted text clipped - 4 lines] > >Then you pay! You're really kind of an a.s. Glad you're not my dentist. >>>Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is >>>probably just sticking some powder in there and stitching.... but I [quoted text clipped - 6 lines] >> >You're really kind of an a.s. Glad you're not my dentist. I guess you are mixing up the internet with a doctor-patient relationship. I am pointing how foolish you are! Joel >>>>Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is >>>>probably just sticking some powder in there and stitching.... but I [quoted text clipped - 13 lines] > >Joel You keep saying I'm foolish, I'm being conned, etc. but you never explain why in a clear manner, at least not until it is dragged out of you. And no, I'm not mixing up the internet wtih a doctor-patient relationship at all, I am simply pointing out that when you make comments in answering questions 1) they are often sarcastic; 2) they are often cryptic or unclear at best; and 3) you seem to have some kind of attitude behind your comments that does not benefit you. Maybe it's just the net; these discussion groups bring out the worst in some people. I appreciate most of your comments when they are clear and without sarcasm. >>>>>Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is >>>>>probably just sticking some powder in there and stitching.... but I [quoted text clipped - 17 lines] >explain why in a clear manner, at least not until it is dragged out of >you. REPLY Interesting observation! You are correct. The internet is not a lesson in dentistry so much as it is a lesson in logic. Most people, say 90% of the population will not respond when a clear concise explanation is given. So I am opening a small window for you to do some work and figure it out for yourself. YOUR RESPONSE so far is Joel M. Eichen is an a.s. Now do I have that right? Joel >And no, I'm not mixing up the internet wtih a doctor-patient >relationship at all, I am simply pointing out that when you make [quoted text clipped - 6 lines] >I appreciate most of your comments when they are clear and without >sarcasm. >Interesting observation! You are correct. The internet is not a lesson >in dentistry so much as it is a lesson in logic. [quoted text clipped - 8 lines] > >Joel Yes, you do have that right. You can do what you want. But people don't come here to play games with you and have you "open a small window so they can do some work and figure it out". As far as I'm concerned that is not what these groups are for at all. They (other dentists or dental students) come here to discuss dentistry; or they (patients) come here to ask questions of knowledgeable students and dentists. If you want to play games with them, that is your prerogative, but I think you are indeed being an a.s most of the time. As I acknowledged below, you sometimes do answer questions and offer good advice/information. But the rest of the time you are an a.s. Why not just answer people's questions clearly and concisely to the best of your ability and leave it at that? >>And no, I'm not mixing up the internet wtih a doctor-patient >>relationship at all, I am simply pointing out that when you make [quoted text clipped - 6 lines] >>I appreciate most of your comments when they are clear and without >>sarcasm. >>Interesting observation! You are correct. The internet is not a lesson >>in dentistry so much as it is a lesson in logic. [quoted text clipped - 14 lines] >and figure it out". As far as I'm concerned that is not what these >groups are for at all. Oh jeez, you did not tell me you got to sci.med.dentistry through a portal. We have questions here from spoonfeeding@sci.med.dentistry too. If you replied through spoonfeeding, my apologies! Joel >They (other dentists or dental students) come here to discuss >dentistry; or they (patients) come here to ask questions of [quoted text clipped - 15 lines] >>>I appreciate most of your comments when they are clear and without >>>sarcasm. > But the rest of the time >you are an a.s. Why not just answer people's questions clearly and >concisely to the best of your ability and leave it at that? Because you are confused, not about the dentistry, nor about which procedure is better to follow. You have heard from me and you have heard from Dave King who is an experienced and talented oral surgeon down my way. If someone is HAVING an implant in three months I can understand someone saying, bone fill. I did not see where you have PAID for the procedure, and you are waiting for, 1. Extraction. 2. Bone fill 3. Healing 4. Surgical placement 5. Restorative crown. PACKAGE DEAL Or am I wrong? Did you cut the check already? If not, why not? For the family room on the back of my house, I had to give them the $20,000 first payment BEFORE they sent in the first guy to turn a shovelful of dirt! How come dentistry is different? PS~ This is example. I have no family room in back. Joel >> But the rest of the time >>you are an a.s. Why not just answer people's questions clearly and [quoted text clipped - 20 lines] > >Or am I wrong You are wrong. You seem to not know that much about implants. You almost never pay up front, you put a deposit down. I plan to do that as soon as I decide WHO (not IF) is doing my implants, and how many I am doing. Also, the oral surgeon told me, as did at least one person here on this group, that it IS a good idea to get the bone graft at the time of the extraction. Otherwise it will be more difficult and costly to do later, if even possible to do later. The extraction is happening today, as will the bone fill unless the oral surgeon decides the bone fill is not going to work, for some reason. Next step is to find out who will do my implants for a reasonable price and THEN pay them whatever they require to start the process. >>>Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is >>>probably just sticking some powder in there and stitching.... but I [quoted text clipped - 6 lines] >> >You're really kind of an a.s. Glad you're not my dentist. You're really kind of an a.s. Glad you're not my patient. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >You're really kind of an a.s. Glad you're not my patient. The feeling is mutual, I ass-ure you. >Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is >probably just sticking some powder in there and stitching.... but I [quoted text clipped - 8 lines] >that saying, "Those who can, do; those who can't, teach"? I hope he is >one who can, and also teaches! .....and those who cannot teach, teach gym. >Thanks for the explanation! > Thanks, Steve, for the reply and opinion. I'm guessing the O.S. is > probably just sticking some powder in there and stitching.... but I [quoted text clipped - 10 lines] > > Thanks for the explanation! Heh heh--I taught at NYUCD 1979-81. I have no other comment. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Jim, I am happy that Dr. Bornfeld answered your question. I am sorry that the other thread got sidetracked (by me and Joel). I hope you do not mind if I expand on this subject just a tad. Medtronic's spinal division (Sofamor Danek) markets a bone morphogenic protein (BMP-2) called Infuse. This protein eliminates the need for harvesting pelvic bone (the traditional method used) in spinal reconstructive surgery. I am not aware if this is yet being used by oral surgeons for such cases as described by Dr. Bornfeld. Does anyone know? I am just curious. Thank you, Sue PS Sorry to interrupt this conversation Jim. It seems your question has been answered! :-) FYI- Interesting link: http://www.newscientist.com/article.ns?id=dn6333 like it was said it could be the material used and type of membrane, the size of the graft, membrane and other chemicals used such as emdogain which is expensive stuff and the labour to put everything together. Also remember there is probably sales tax involved with membranes, sutures etc... which can also drive the cost up. |
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