Bone Grafting

Major and minor bone grafting

Over a period of time, the bone in the upper jaw (maxilla) and lower jaw (mandible) will resorb if a tooth is missing or affected by an infection such as periodontal disease or an abcess. This often leaves a condition in which there is poor quality and/or quantity of bone suitable for placement of dental implants. To build back the bone, which is needed for an implant, we use a variety of bone grafting techniques. This not only allows us the opportunity to place implants of proper length and width, it also gives us a chance to restore the tooth to its original function and aesthetic appearance. We have been using the following bone grafting procedures with great success.

The Socket Preservation Graft

Careful management of extraction sockets at the time of tooth removal prevents unsightly bone loss and a better cosmetic result whether a tooth is to be replaced with a bridge or an implant. The socket preservation graft can help manage the extraction site and is used immediately after a tooth or teeth are extracted. After an extraction, there is loss of soft tissue (gums) and bone around a tooth that had periodontal disease or has been infected for some time. Also, some extractions are difficult and require some bone to be removed to extract the entire tooth. Therefore, to replace the missing bone and to augment the bone to its natural and original state, we graft the socket and surrounding tissue immediately after the extraction. The bone is obtained from a bone bank and is in the form of particles. This bone is placed into the extraction site and a collogen plug is placed and secured. This technique not only augments the tissue but it preserves the normal contours of the bone and soft tissue. We have found greater success of the future implant with this technique since the normal architecture of bone and soft tissues have been preserved to a greater extent The patient’s surgery time at the time of implant placement and the need for further grafting is minimized. The implant can be placed in a more natural position which facilitates obtaining the best possible esthetic and functional result.

Block bone grafts

Sometimes, the width and height of bone are insufficient to place an implant in the proper position. In this case, we need to augment the bone to allow correct placement of the dental implant. To do this, bone is usually removed from the third molar area and placed in the area where it is needed. Your own bone (autogenous bone) is the best type of bone to use in areas of the jaw that need greater thickness. This block graft is secured in place with small screws. The graft is allowed to fuse to the natural bone for 3 to 4 months. At the time of implant placement, the small screws are removed. We have found that by using the patient’s own bone, not only is the implant more secure but less time is needed before the crown is placed on the implant.

Sinus lift bone grafting technique

This is a very easy procedure to provide bone for implants in the back of the upper jaw. A small window is made on the side of the upper jaw (maxilla) under the tissue to expose the maxillary sinus. The membrane lining the sinus is elevated and a bone graft material is added under the membrane. The tissue is closed over the window and allowed to heal. The bone graft material will form new bone in about 6 months. After that time, implants are placed in their position for the future crowns.
Sometimes there is enough bone to stabilize the implant but not enough for long term function. In this case an implant can be placed at the time of sinus grafting, this allows a shortened time before restoration and functioning of your new tooth.

Guided Tissue Regeneration

Guided tissue regeneration is used when there is a localized defect in the bone or only slightly inadequate bone in the area of implant placement. This technique allows us to grow bone in an area to facilitate proper implant placement. Your own bone is often used alone or in combination with another bone graft matrix if additional volume is required. This bone is then covered with a barrier membrane that allows nutrients to gain access to the area to help healing but excludes skin cells which would hinder healing. The graft bone is then turned into your own bone in this area over a period of approximately 4 months.