Oral-Maxillofacial and Implant Surgery
BONE GRAFTING AND ADVANCED TISSUE GRAFTING
Major & Minor Bone Grafting
WHAT IS BONE GRAFTING?
Over a period of time, the jaw bone associated with missing teeth atrophies and is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for the placement of dental implants. In these situations, most patients are not candidates for the placement of dental implants.
Since implants are "screws" placed in the bone, the more bone that is available, the better the implant that can be placed.
With bone grafting we now have the opportunity to not only replace bone where it is missing, but we also have the ability to promote new bone growth in that location. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.
It is easier to maintain existing bone than to have to come back and build lost bone. Thus, the best time to graft bone for future implant placement is at the time of extraction.
MAJOR BONE GRAFTING
If a patient does not have bone grafting done at the time of the procedure or if many years have passed since the extraction, there may not be enough bone for an implant.
There are several other causes for loss of bone including periodontal disease, pathology and trauma.
In such instances, other methods of bone grafting need to be done to rebuild bone for an implant.
There are several bone reconstructive methods that Dr. John performs to rebuild bone.
1. Guided Bone Regeneration.
This is the simplest of all the bone regeneration procedures.
Here special membranes may be utilized that dissolve under the gum to protect the bone graft, as well as encourage bone regeneration.
2. Tenting Screws
In this method, screws are placed at the site with bone graft and membranes to increase the height/width of bone.
In sites of compromised healing, blood products can be filtered and used with particulate bone graft material to improve the healing.
4. Sinus Lift (sinus augmentation)
The upper back jaw contains the sinus. (Yes, the one can usually causes sinus infections). Below the sinus is the bone where the teeth and the implants are. The larger a person's sinus, the smaller the height of bone below it. Many times, a large sinus means that there is not enough vertical bone for an implant.
In these cases, a sinus lift procedure needs to be done. In this procedure, Dr. John will place bone graft inside the sinus, many times in conjunction with implant placement. As a result, the implant is not poking up into the air of the sinus, but is covered by bone on all sides.
5. Ramus/Chin Block Graft
If there is vertical loss of bone, Dr. John will remove a small segment of bone from the chin or the ramus of the mandible (lower jaw), and place it at the deficient site. After a period of healing, there should be sufficient height of bone for an implant.
6. Split Ridge procedure
If the width of bone is too narrow for an implant, Dr. John can split the bone and widen it. Depending on the existing bone, an implant can be placed at the same time or later, after a period of healing.
7. Bone Transposition
In certain areas, especially the lower front jaw, a segment of horizontal bone can be sectioned and moved up and bone graft can be placed in between the two segments. This can increase the height of the bone.
8. Iliac Crest etc
In significant loss of height and width of bone, especially due to trauma or pathology, bone graft can be taken from the hip and placed in the oral cavity.
These procedures are routinely performed in an operating
room and require a hospital stay.
When you come in for a consultation, Dr John will take a CT scan and will evaluate the most appropriate procedure for your situation.
Many of these major bone grafting procedures can be avoided by performing a simple bone graft at the time of the extraction and having the implant placed sooner than later.