Bone Grafting For Implants
Why Bone Grafting?
Today, bone grafting procedures have become almost an integral part of implant reconstruction at our office in Dallas. In many instances, a potential implant site in the upper or lower jaw does not offer enough bone volume or quantity to accommodate a root form implant of proper size or in the proper place. This is usually a result of bone resorption (shrinkage) that has taken place since the loss of the tooth. Bone grafting procedures are utilizes to re-establish bone dimension. We now have the ability to grow bone where it is needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore function and a pleasing esthetic appearance. The bone graft procedures are divided into two classes: ridge bone augmentation and sinus augmentation.
Bone augmentation is a grafting procedure used to repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is obtained from the patient’s mouth or artificial bone substitutes. Special membranes are utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. These special membranes help guide bone regeneration. Grafting is performed in the office either in conjunction with the implant placement or as separate procedure. Dr. Orth will discuss these options with you.
In extremely rare cases major bone grafts are necessary to repair larger defects of the jaws. These defects may arise as a result of severe traumatic injuries (auto accidents etc.), tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. The bone is harvested from different parts of the body outside of the mouth. The hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.
Before and after Bone Augmentation
Dr. Orth is surgically trained if these procedure are necessary.
|Normal bone tooth||After bone loss, after tooth loss|
|Bone grafting for implant||Bone grafting with implant place|
The maxillary sinuses are behind your cheeks and on top of the upper teeth. These sinuses are empty, air-filled spaces. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.
The Sinus Augmentation Procedure:
The key to a successful and long-lasting dental implant is the quality and quantity of jawbone to which the implant will be attached. If bone loss has occurred due to injury or periodontal disease, a sinus augmentation can raise the sinus floor and allow for new bone formation.
In the most common sinus augmentation procedure, a small incision is made on the premolar or molar region to expose the jawbone. A small opening is cut into the bone, and the membrane lining the sinus is pushed upward. The underlying space is filled with bone grafting material, either from your own body or from a cadaver. Sometimes, synthetic materials that can imitate bone formation are used. After the bone is implanted, the incision is stitched up and the healing process begins. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.
If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.
The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option besides wearing loose dentures.
Sinus Augmentation Case Studies Performed by Dr. Orth
Case 1: Before and after Sinus Augmentation
Case 2: Before and after Sinus Augmentation
What is a ridge Preservation?
A ridge preservation is a common dental procedure often performed following a tooth extraction to help recreate the natural contour of the gums and jaw that may have been lost due to bone loss as a result of a tooth extraction, or for another reason.
The alveolar ridge of the jaw is the bone that surrounds the roots of teeth. When a tooth is removed, an empty socket is left in the alveolar ridge bone. Usually this empty socket will heal on its own, filling with bone and tissue. Sometimes when a tooth is removed, the bone surrounding the socket breaks, and it unable to heal on its own. The previous height and width of the socket will continue to deteriorate.
Rebuilding the original height and width of the alveolar ridge is not medically necessary, but may be required for dental implant placement, or for aesthetic purposes. Dental implants require bone to support their structure, and a ridge augmentation can help rebuild this bone to accommodate the implant.
How is a ridge Preservation accomplished?
A ridge preservation is accomplished by placing bone graft material in the tooth socket. It is often done immediately after the tooth is removed, to avoid the need for a second procedure later. Next, the gum tissue is placed over the socket and secured with sutures. Dr. Orth may choose to use a space-maintaining product over the top of the graft to help restore the height and width of the space created by the tooth and bone loss, and into which new bone should grow. Once the socket has healed, the alveolar ridge can be prepared for dental implant placement.
A ridge augmentation procedure is typically performed in Dr. Orth’s office under local anesthesia. Some patients may also request sedative medication in addition.