Over time, the bone in the lower jaw (mandible) and upper jaw (maxilla) will resorb or diminish if a tooth is missing or affected by an infection such as an abscess or periodontal disease. This creates a condition in which there is poor quantity or quality of bone suitable for dental implant placement. To build back the bone, which is necessary for a dental implant, our oral and maxillofacial surgeons use several bone grafting techniques. Not only does this allow us the opportunity to place implants of proper width and length, it also gives us a chance to restore the tooth to both its original function and aesthetic appearance. Studies also indicate that implants have longer lifespans and better aesthetics with adequate bone support. At Loudoun Oral and Maxillofacial Surgery, we have had great success combining bone grafting procedures with the latest bone grafting technology.
Socket Preservation Graft
After an extraction, some of the soft tissue (gums) and bone around a tooth that has been infected for some time or had periodontal disease is lost. Some extractions are difficult and may require the removal of additional bone material in order to extract the entire tooth. The bone may also be very thin to start with. When necessary, bone is placed into the socket at the time of extraction to avoid the collapse of the socket (up to 60% loss of bone width in the first year after extraction). This grafted bone will augment the site to its natural and original state.
Bone material, in the form of particles, is obtained from a bone bank. This bone is placed into the site of the extraction. Then we will place and secure a dissolvable barrier to the oral environment. This technique not only augments the tissue, it also helps preserve the normal contours of surrounding soft tissue and bone. We have found that socket preservation grafts offer greater success for a future implant since the normal architecture of soft tissues and bone has been preserved to a greater extent. In addition, the amount of surgery time and need for further grafting is minimized. The implant can also be placed in a more natural position, facilitating the best possible functional and aesthetic result.
Careful management of the extraction sockets at the time the tooth is removed will prevent unsightly bone loss as well as a better aesthetic result, regardless of whether a tooth is to be replaced with a dental implant or a bridge. A socket preservation graft can help manage the extraction site, and is employed immediately after one or more teeth have been extracted.
Block Bone Graft
Sometimes, the height and width of a patient’s existing jawbone are insufficient to place an implant properly. In this case, our oral surgeons may need to augment the bone. To do this, we will frequently remove bone from the third molar area and place it in the area that needs to be augmented. Your own bone (autogenous bone) is the best type of bone to use in the areas of the jaw that require greater thickness.
Block grafts are secured in place with small screws. The graft is allowed a period of approximately four to five months to fuse to the surrounding natural bone. At the time the implant is placed, the small screws will be removed. Our doctors have found that by using the patient’s own bone, the implant will be more secure and less time will be needed before the crown attached to the implant.
Sinus Lift Bone Grafting Technique
A sinus lift is a very common procedure designed to provide bone for implants in the back of the upper jaw. First, a small window is made under the tissue on the side of the upper jaw to expose the maxillary sinus. The membrane lining of the sinus is elevated, and the bone graft material is placed under the membrane. The tissue is then closed over the window and allowed to heal. Over the next six months, the bone graft material will form new bone. After that time, dental implants are placed in their position for the attachment of future crowns.
Sometimes there is enough bone present to stabilize the implant, but not enough for actual long-term function. In this case, a dental implant can be placed at the time of sinus grafting, allowing for a shortened time before the restoration and function of your new tooth.
Guided Bone Regeneration
Guided tissue regeneration is used when the bone has a localized defect, or the bone in the desired implant area is only slightly inadequate. Guided tissue regeneration allows our surgeons to grow the necessary bone in an area to facilitate proper placement of the implant. Most often, banked bone will be used alone or in combination with your own bone to provide volume for the graft. This bone material is then covered with a barrier membrane which allows nutrients necessary for healing to gain access to the area, but denies access to gum tissue cells that would hinder healing. Over a period of about four months, the graft bone is then turned into your own bone in this area.