When a dental implant patient’s jawbone has lost its shape or receded due to tooth loss and aging, it can often be augmented in order to replace missing bone and encourage new bone growth. Depending on where the bone loss has occurred, one of the following procedures will be selected – sinus graft, ridge preservation or bone graft.
A sinus graft increases the thickness of an area of the upper jawbone and the sinus floor. The ridge preservation procedure fills the empty socket of a newly removed tooth. A bone graft restores the thickness and height of the jaw where the bone has diminished in the initial years following tooth loss.
For all 3 of these procedures, the first step is the preparation of the material which is going to be used to replace the missing bone. It may consist of either the patient's own bone, bone mass from an animal or human donor source.
There are several bone grafting techniques used in oral surgery which can be grouped into 2 different types – pre-operative and inter-operative. The most extensive type of bone grafting is pre-operative which is carried out a significant amount of time – usually several months – prior to the implant being placed and it is used to make significant changes to the size and shape of the jaw. And, inter-operative bone graft is carried out immediately preceding the implant placement and is used in instances where the patient does not have enough bone thickness to fully cover the implant.
With both types of bone graft procedure, the gum is opened to expose the jawbone, the donor bone grafting material is placed in the area where the jawbone has receded and the gum tissue is sealed with stitches.
In the human body, the sinuses are located below the eyes immediately above the upper jawbone. Bone absorption can occur following the loss of upper teeth below this area and over a period of time the sinus will expand into the area where tooth root and jawbone previously were. A dental implant placed in an inadequate area of bone mass will not have the stability to withstand the everyday forces of chewing and biting food.
Typically for a sinus graft to be carried out, small incisions are made to create a flap in the sinus wall in the area of the missing tooth. A surgical instrument is used to move the sinus to its original position creating an area for the substitute bone to be placed. The bone graft material is then placed on the sinus floor and flap of skin is sealed with stitches. In most instances, the implant can be placed at the time of the sinus lift procedure and an abutment and crown will be fitted after the new bone and implant become fully integrated with each other and the existing bone.
The ridge preservation procedure is carried out immediately after a tooth has been extracted to prevent the jawbone from being absorbed. The empty tooth socket is filled with donor bone material following the removal of the tooth. In some cases it is also necessary to treat the bone grafting material with specially formulated plasma which is high in human blood platelets to quicken the healing process and enhance bone growth. The plasma is created from the patient's own blood which eradicates the possibility of rejection. A barrier is also placed over the opening to prevent the gum tissue from becoming integrated with the grafted bone material. Finally, the opening is sealed with surgical stitches and a healing period of up to 6 months is allowed for the new bone mass to grow before the implant can be placed.
The Impact on Treatment
The developments in new bone augmentation techniques over the last 2 decades enable implant treatment to be carried out in cases which would have been previously impossible to treat.
All of these procedures – which are normally performed by a periodontist or an oral surgeon – result in restoring or preserving the patient's jaw in order for a dental implant to be placed and will increase the total cost of treatment, healing times and require additional dental appointments.
The latest techniques in bone augmentation are used by Dentists in their four dental implant clinics in different areas of Southern England. They are dedicated to providing advanced dental treatments of the highest standards whilst maintaining the lowest cost Teeth Implants in the UK.