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. In these situations, most patients were not candidates for placement of dental implants.
Recently, bone grafting technology which is well proven in the orthopedic field is being applied to the benefit of our oral surgery patients. A naturally occurring protein has been synthesized that stimulated the patients’s body to form bone in these areas where it is needed for implant placement. 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.
Major Bone Grafting
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 bone stimulating protein in combination with the patient’s own bone. This bone is 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 Graft Procedure
The maxillary sinuses are behind your cheeks and on top of 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.
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 well, sinus grafting and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus grafting will have to be performed first, then the graft will have to mature for several months. Once the graft has matured, the implants can be placed.
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 gets too thin to place conventional implants. In these procedures, the bony ridge of the jaw is either expanded by mechanical means or augmented with guided bone regeneration techniques. Bone graft material can be placed and matured for a few months before placing implants.
These surgeries are performed in the office surgical suite under local and IV anesthesia. After surgery, rest is recommended for one day and limited physical activity for several days.