Replacement teeth supported by dental implants function so well and last so long because, like natural teeth, they are securely anchored in the jawbone for maximum support. In order to benefit from this remarkable technology, however, you need to have enough tooth-supporting bone in your jaw to hold a dental implant in place. Unfortunately, after tooth loss, the surrounding bone almost always deteriorates — decreasing in width, height and density — and this process starts immediately. The longer a tooth has been missing, the more the bone that used to surround it resorbs (melts away). If you want a dental implant but don't have enough bone to support it, can anything be done? Yes. Very often you can still get the replacement tooth you want, thanks to routine bone grafting procedures.
How It Works
Bone grafting, normally a minor surgical procedure done in the dental office, is used to build up new bone in the area of your jaw that used to hold teeth. A small incision is made in your gum to expose the bone beneath it, and then grafting material is added. Most often, the grafting material is processed bone that serves as a scaffold, around which your body will actually deposit new bone cells. The grafting material will eventually be absorbed by your body and replaced by your own new bone.
The grafting material needed can come from a variety of sources. Sometimes it comes from your own body. Very often, however, it is bone from an animal or human donor that is processed by a laboratory to make it sterile and safe. Grafting material can even be synthetic. It comes in a variety of forms: powder, granules, putty or even a gel that can be injected through a syringe.
Types of Bone Grafts
There are a variety of sources of bone grafting material used for preserving or augmenting bone for dental implants. All of these bone grafting materials are backed by significant research. They are processed (except autografts, which do not need processing) so that they are safe to use, eliminating the potential for rejection or disease transmission.
- Autograft: If you are already familiar with the concept of bone grafting, an autograft is probably what you're thinking of: taking bone from one site in your body and moving it to another. This is the only type of bone graft that involves creating two surgical sites: the one from which the bone is harvested and the one where it is deposited.
- Allograft: This refers to laboratory-processed human bone from a deceased donor that comes from a tissue bank.
- Xenograft: This bone grafting material comes from an animal — usually a cow.
- Alloplast: This type of graft uses synthetic (man-made) materials.
What to Expect
The procedure for placing a bone graft usually requires only local anesthesia, though oral or IV sedatives can also be used to achieve a higher state of relaxation. Because a small incision in your gum tissue needs to be made to access the underlying bone that will receive the graft, you may experience some soreness in the area after the surgery; this can usually be managed by over-the-counter anti-inflammatory medication and/or pain relievers as well as ice therapy after the procedure. Though you will soon feel completely back to normal, it may take your body up to seven months for bone maturation to take place to receive your dental implant. The waiting time allows the healing process enough time to achieve the desired result: ideal support for replacement teeth that look great and will last a lifetime.
What is Ridge Augmentation? This is a procedure commonly performed when teeth have been removed resulting in a significant bone loss (shrinkage of the bone). Without growing bone, procedures such as dental implants may not be possible. By using various types of bone grafting materials, Dr. Levine can rebuild the height and width of the lost bone, not only to prevent further deterioration but also to accommodate placement of implants.
Sinus Lift Procedure
What is a Sinus Lift? The maxillary sinuses are large air-filled spaces that are located above the upper back teeth. They can vary in size and can actually become larger as we grow older. Because the roots of the upper teeth can naturally extend into the sinuses, there may only be a small amount of bone left after these teeth have been extracted. Because of this, there may not be enough bone to place an implant.
Implant success is very much determined by the amount and quality of the bone into which it will be placed. If there is minimal bone under the sinuses, the sinus floor can be raised so that new bone can form that will accommodate an implant. This is probably one of the most common bone grafting procedures that we perform in the upper jaw.
How is the Sinus Lift Procedure Performed? For most of these procedures, a small opening is made through the gum tissue to expose the underlying bone in the molar and/or premolar region. An opening is then made into the bone which exposes the sinus membrane. The membrane is lifted and the bone grafting material can be placed which maintains the new height of the membrane. The incision is then closed and the healing process can begin. Many times the implants can be placed at the same time as the sinus graft. After a few months of healing, the implants are stabilized and ready to be restored. The sinus lift graft allows for implant placement in many patients when, years ago, they may have been told that they were not candidates for implants and had to tolerate loose fitting dentures.
Preserving the Jaw Bone after a Tooth Extraction - Teeth may need to be removed for a variety of reasons. The problem can be pain or an infection, possibly caused by decay or a fracture. The bone that supports the tooth (the alveolar bone) many times will be damaged by this disease process, causing loss of bone. Removing a tooth like this may result in a defect in the bone that could cause major problems for future treatment involving dental implants, dentures, or bridges. By doing a socket preservation procedure at the time of the extraction, you can increase the success of your dental implants and improve your smile. Dr. Levine may use several techniques to minimize the bone loss after tooth removal, thereby preserving the bone in that area. One very common method is to fill the extraction socket with bone or a bone substitute at the time the tooth is removed. The gum is closed over the filled socket, sometime after covering the graft with a membrane. The bone will now begin to heal eventually providing the bone necessary for implant placement. This is very important if you are planning to replace your front teeth, so be sure to ask if socket preservation is necessary.