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 the placement of dental implants. In these situations, most patients are not candidates for dental implant placement.
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.
Alveolar Ridge Preservation
Socket preservation, also known as alveolar ridge preservation, is a oral surgery procedure performed after a tooth extraction to minimize bone loss and maintain the shape and dimensions of the tooth socket or alveolar ridge. When a tooth is extracted, the surrounding bone may undergo resorption, leading to a reduction in bone volume and changes in the contours of the jawbone.
Socket preservation aims to prevent or minimize this bone loss by placing a bone graft or a bone substitute material into the empty tooth socket immediately after extraction. This helps to fill the space left by the extracted tooth and provides support for the surrounding tissues.
By preserving the socket in this way, dental professionals aim to maintain the bone structure, making it more suitable for future dental implants or other tooth replacement options. Dental implants require a stable and healthy jawbone for successful placement, and socket preservation can help achieve this goal.
Sinus Lift Procedure
The maxillary sinuses are located behind your cheeks and on top of the upper teeth. These sinuses are essentially empty spaces. Some of the roots of the natural upper teeth extend 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 require bone to hold them in place. When the sinus wall is very thin, it becomes impossible to place dental implants in this bone.
There is a solution called a sinus graft or sinus lift graft. The dental implant surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is 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.
The sinus graft makes it possible for many patients to have dental implants when, years ago, there was no other option other than wearing loose dentures.
If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant, 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, and then the graft will have to mature for several months, depending on the type of graft material used. Once the graft has matured, the implants can be placed.
Ridge Expansion
In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. This is a technique used to restore the lost bone dimension when the jaw ridge becomes too thin to place conventional implants. In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the implant.
Major Bone Grafting
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, hip, or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft, encouraging bone regeneration. This is called guided bone regeneration or guided tissue regeneration.
Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s bone harvested from various 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 may require a hospital stay.