The bone of our upper and lower jaws exists to hold the roots of our teeth. If a tooth is removed, or if we are born without a particular tooth, the jaw bone has no stimulus or no reason to exist in that area and it slowly begins to atrophy, or “melt away”. Dental implants require an adequate amount of bone in order to successfully integrate into the jaws. Therefore, “implants are all about bone”. If significant atrophy of the jaw bone has occurred this could prevent the patient from receiving a dental implant.
Fortunately, there are techniques that we can use to replace missing bone. These techniques are called grafting procedures. Grafting procedures can sometimes be done in conjunction with implant placement, or sometimes the grafting (build up of bone) needs to precede implant placement.
At the time of your consultation we will carefully assess the amount of available bone for implant placement. There are different radiographs at our disposal that we can order depending on the area and degree of bone loss. Sometimes all that is needed is a panoramic x-ray called a panorex that we can take in our office.
Other times it is necessary to take a more sophisticated x-ray called a computerized axial scan, or CT scan. CT technology has progressed at a rapid pace. CT scans can now be taken quickly with minimal radiation exposure. These images can then be reconstructed using a computer format giving Dr. Antonious a 3D image of your jaw. The surgery can then be preformed on the computer prior to being done on the patient.
Different types of grafting procedures are described below. If bone grafting is required in conjunction with your implant surgery, or needed prior to implant placement we will make the appropriate recommendation and cover the procedure in detail with you at the time of your consultation.
As described above, when a tooth is removed the bone in the area begins to be resorbed. At the time of tooth extraction, if a dental implant is planned to replace the tooth, then we want to preserve as much bone as possible. It is always easier to preserve bone, rather than try to reconstruct it at a later date. Placing a bone graft material into the socket site at the time of tooth removal is called a socket graft, or ridge preservation technique.
The graft material is designed to “fool Mother Nature” and keep the “plump” and “full” for future implant placement. The graft material is not designed to be a part of your body forever, but rather to serve as a scaffold for the in growth of your own bone. The graft material is slowly resorbed and replaced with your own bone over a period of 3 to 4 months. The area is then re-evaluated and often we can proceed with implant placement without any additional grafting.
The graft material we use is an allograft material and therefore is cadaver bone. This bone has been irradiated and sterilized so that it cannot transmit disease, but yet it retains important minerals that can help with the growth of your own bone into the area.
Sinus lift procedure
This procedure involves elevating the sinus membrane and placing bone graft material onto the sinus. This graft material consolidates and is replaced by the patients own bone. This new volume of bone then allows dental implants to be placed in the back regions of the upper jaw.
Onlay Bone Grafting
Such grafting procedures may be performed separately or together, depending upon the individual’s condition. There are several areas of the body which are suitable for attaining bone grafts. In the maxillofacial region, bone grafts can be taken from inside the mouth in the area of the chin, or further back in the third molar region. In more extensive situations, a greater quantity of bone can be attained from the hip or from the outer aspect of the tibia in the knee.