Doctors have suggested that my 56 year old father have bone taken from his hip and transferred to his mouth because the bone there has decayed, and I am worried about the risks involved with a surgery like this for an older person who has diabetes. Is there anything we, his family, can do to reduce those risks?

The risks are high for possible bone infections. Bone grafts are rarely done anymore because of the wide variety of sizes of dental implants to be used to retain a denture prosthesis. Bone does not decay. Without teeth the bone has no reason to be there and you get bone resorption. If he has severe resorption, I would recommend a bone density scan and additional hormone testing to rule out other metabolic conditions that would cause this (i.e., thyroid disease, parathyroid problems). If he has had or is currently on steroid therapy, this will also cause bone loss. If he has no other options but a bone graft, then I would recommend hyperbaric oxygen therapy (about twenty dives before and ten after surgery). I would also recommend using the fibula with arterial graft instead of the hip, but this again depends on a variety of factors — for example, does your father have peripheral vascular disease.

In short, the more conservative the therapy the better the outcome generally. The surgery consultations should be done with the restorative dentist and they should develop good communication and develop a team approach.

FV

[Editor’s comment: See Surgery Pre-Op Advice for some additional thoughts.

WWQ]