Over a period of time, the jawbone resorbs as a result of missing teeth due to extractions, gum disease or injuries. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants, which are the best alternative to replace missing teeth. In these situations, most patients are not candidates for placement of dental implants.
Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance.
Minor Bone Grafting
The bone is either obtained from a tissue bank or your own bone is taken from the jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration.
Major Bone Grafting
Large grafts are performed to repair defects of the jaws as a result of traumatic injuries, tumor surgery, or congenital defects. These are repaired using the patient’s own bone harvested from different sites like the cranium, hip (iliac crest), and lateral knee (tibia). Stem cells, growth factors, bone morphogenetic protein and banked bone can be used also. These procedures are routinely performed in an operating room and require a hospital stay.
Sinus Lift Procedure
The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Sometimes there is thin wall of bone separating the maxillary sinus and the mouth. When the sinus wall is very thin, it is impossible to place dental implants in this bone. During the procedure the surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and bone is inserted into the floor of the sinus. The functions of the sinus remain intact after this procedure. After several months of healing (3-6), the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.
In 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.
Synthetic materials can also be used to stimulate bone formation but the most advanced techniques include the use of growth factors from patients own blood (platelet rich plasma), bone forming proteins (bone morphogenetic protein) and stem cells.