Over a period of time, the jaw bone area associated with missing teeth shrinks. This results in loss of quality and reduced amount of bone suitable for placement of dental implants. Today, we have the ability to replace bone where needed. This not only gives us the opportunity to place implants of precise length and width, but also allows us to restore function and aesthetics.
Major Bone Grafting
Bone grafting can enhance implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. We typically use your own bone, taken from the jaw, hip or tibia. Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft, encouraging bone regeneration. This is call guided bone regeneration. Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery or congenital defects. Large defects are repaired using the patient’s own bone. This is harvested from a number of different sites depending on the size of the defect. These procedures are routinely performed in an operating room and may require a hospital stay of one or two days.
Sinus Lift Procedure
The maxillary sinuses are above your upper posterior teeth. Some of the roots of upper teeth extend up maxillary sinuses. When these upper teeth are removed, there is often a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone. The solution for this is termed Sinus Lift or Sinus Graft. As part of this procedure, Dr. Blazic makes an incision at the sinus area where the teeth used to be. The sinus membrane is then lifted upward and bone is inserted into the floor of the sinus. After several months of healing, the bone becomes part of the patient's jaw. At this point, the dental implants can be inserted and stabilized in this new sinus bone.
The sinus graft is a revolution in dental implant treatment plans. Years ago, there were no options other than loose fitting dentures. If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation must be performed first, followed by graft maturation for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.
Ridge Expansion
In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. This technique is used to restore the lost bone dimension when the jaw ridge gets too thin to place dental implants. As part of this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the implant.
Nerve Repositioning
The inferior alveolar nerve, which gives feeling to the lower lip and chin, may need to be repositioned in order to make room for dental implant placement in the lower jaw. This procedure is limited to the lower jaw and is indicated when teeth are missing in the area of the back two molars and/or the second premolar. This procedure is considered a more aggressive approach. Post-operatively, there is almost always some numbness of the lower lip and jaw area. This numbness may resolve over time, or it may not resolve at all. Other less aggressive options are considered first. Typically, removal of the outer wall of the lower jaw bone exposes the nerve. The nerve can then be isolated and pulled out to the side. At the same time, Dr. Blazic will place the implants. The nerve is then placed back over the implants. The surgical access is refilled with bone graft material and the site is closed.
These procedures may be performed separately or together, depending upon the patient’s condition.
