Major & Minor Bone Grafting
Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants.
Socket Preservation Grafting
After a tooth is extracted, the jawbone in the area decreases in size as it heals. If an implant is planned to replace the missing tooth, it is often preferable to place bone grafting material in the socket at the time of extraction. This helps to minimize the bone resorption and provide for optimal placement of the implant. The graft material of choice for this procedure is often bone from a tissue bank and a resorbable membrane made of collagen can be used to hold it in place. After a period of healing, the patient’s own bone fills the socket and the implant can be placed.
Today, we have the ability to grow bone where needed. 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.
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw or hip. Special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.
Large bone grafts can also be performed to repair defects of the jaws caused by traumatic injuries, tumor surgery, or congenital defects. Large defects may be repaired using the patient’s own bone. This bone may be harvested from a number of different sites depending on the size of the defect. The skull (cranium), 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.
Sinus Lift Procedure
The maxillary sinuses are behind your cheeks and above the upper teeth. Sinuses are like empty rooms that have nothing in them. 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.
There is a solution called a sinus lift graft. The surgeon enters the sinus from above where the upper teeth used to be. The membrane which lines the sinus is then lifted upward and donor bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. 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.