As recently as a few years ago patients were often faced with the startling news: you cannot be the subject of implant surgery, as your jawbone isn’t thick enough to support the implant. Today, thanks to the development of bone grafting techniques, you will no longer hear this. Why does bone volume reduce?
The volume of the jaw bone usually does not reduce while teeth are in place. Chewing forces have a preserving effect and do not allow bone quantity to diminish. Once a tooth is lost, bone resorption begins. Conventional prostheses cannot stop progression, as their transmission of chewing force is not physiological. The solution to minimise bone atrophy is the insertion of an implant as soon as possible. If a tooth has been lost for more than 6 months and has not been replaced with an implant, bone atrophy is very frequent.
In addition, of course, there are various conditions that may reduce bone supply, such as periodontal diseases and osteoporosis.
What materials are used for bone augmentation?
Dental bone graft material can be synthetic bone tissue, processed animal bone tissue (the inorganic elements of purified and sterilized cow bone) or own bone tissue (a bone block of about 1cm2) harvested from natural healthy bone, usually from the lower jaw (chin or wisdom teeth region) or hip region. These materials can even be combined for the best result.
Ask your dentist about the advantages of the different materials.
How is bone replacement performed?
First, a panoramic X-ray or more often a CT-scan is made to evaluate the bone supply. The procedure requires local anaesthesia and sometimes sedation. Depending on the extent of bone deficiency, different surgeries can be performed:
The simplest type of bone replacement is when there is enough bone for the implant to be placed but not enough to completely cover the sides of the implant. In this case small granules of grafts are used and the implant is usually inserted at the same time.
A more extensive intervention requiring a separate surgery is needed in case of advanced bone loss. After opening the area in question, bone graft granules and bone blocks are used to build up the area. The site is protected with a collagen membrane and closed with sutures.
Implants can be placed months later, when the grafted bone has fused and become an integrated part of the natural bone.
Sinus lift is a special type of bone grafting (sinus augmentation or sinus elevation), performed in the case of missing upper back teeth. The maxillary sinus is a cavity sitting just above the upper molars and after their loss it progressively dips down, resulting in a very thin wall between the sinus and the gum.
After the elevation of the sinus membrane extra bone is grafted onto the sinus floor, thus raising the floor and increasing bone depth. Depending on the situation, implants can be placed right after the sinus lift or after a healing period of 4 months.
To what should I pay attention after bone substitution?
You may need to take antibiotics and pain medication for some days after the surgery. Swelling and bruising are normal for around a week, while tenderness can last even longer. You should avoid blowing your nose, sneezing and bending down for a week.
Note that after a sinus lift you should not travel by plane for a week as air pressure at high altitudes puts the success of the treatment at risk!
What is the advantage of bone augmentation?
Thanks to bone substitution, patients with reduced jaw bone volume also get the chance to experience the advantages of implants.
Contact us today and smile tomorrow!