Bone Grafting Procedures
Major and Minor Bone Grafting
A jaw bone (maxilla/mandible) that is without teeth for an extended period of time will gradually resorb and atrophy (disintegrate or wash away). This often results in a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In most cases where osseointegrated implants are being considered the limiting factor is the amount of bone available to place the implants. The amount of bone may be deficient in either a vertical or horizontal dimension. This lack of viable bone will necessitate a bone grafting procedure to restore the anatomy and allow for proper prosthetic treatment.
We now have the ability to graft autogenous (bone harvested form the same patient) bone when indicated. This gives us the opportunity to place implants of proper length and width, but more importantly it provides the ability to restore proper function and aesthetics.
Depending upon the specific requirements of each patient’s case, bone-grafting procedures may be performed separately or on occasion simultaneously with the placement of osseointegrated implants. There are several areas of the body that are suitable for obtaining bone grafts. In the maxillofacial region, bone grafts can be taken from inside the mouth, in the area of the chin, third molar region or in the upper jaw behind the last tooth. In more extreme cases, a greater quantity of bone may be required and this can be obtained from the hip or the outer aspect of the knee.
Many of these procedures are performed in our office on a daily basis, often with the aid of IV sedation or general anesthesia. In more complex instances the doctors may elect to admit the patient to Hackensack University Medical Center. There are many types of bone grafting techniques and the following is a brief list of some of the procedures that we perform. These techniques are all case specific depending on the many variables that go into to coordinating your case.
Sinus Lift Procedure
This procedure involves surgery above the maxillary posterior teeth. During this procedure we elevate the maxillary sinus membrane and place a bone graft that is harvested from another site in the mouth, onto the sinus floor. This will increase the amount of bone available for implants in a vertical direction and allow implants to be placed in the back part of the upper jaw.
In severe cases the alveolar ridge (the alveolar ridge is the portion of bone in our mouths that generally supports the teeth) is reabsorbed and a bone graft is necessary to increase the ridge height and/or width to accommodate an osseointegrated implant. This procedure involves grafting autogenous bone (bone from the same person’s body) to the desired location in the mouth.
When considering implants in the lower jaw, the inferior alveolar nerve, which gives feeling to the lower lip and chin, may restrict the quantity of bone available to place implants in the posterior aspect of the mandible. We now have the ability to reposition this rather large sensory nerve in order to make room for placement of dental implants to the lower jaw.
Immediate Extraction Socket Graft
Often times an osseointegrated implant is considered as the replacement of choice for an extracted tooth. It may be advantageous to immediately fill the missing tooth socket with an artificial bone substitute to properly prepare the extraction site for ideal implant placement.