Bone Grafting (Building Jawbones)
Over a period of time, the jawbone associated with missing teeth atrophies or melts away. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. 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 aesthetic appearance.
When teeth are extracted due to disease, fracture, etc., it is often recommended to place particulate bone grafting material within the tooth socket so as to maximize the bony ridge dimensions upon healing. If grafting material is not placed within the tooth extraction socket, the bony ridge tends to narrow over time potentially leaving inadequate ridge anatomy to place implants.
In severe cases, the ridge has been resorbed and a bone graft is placed to increase ridge width and/or height. This is a technique used to restore the lost bone dimension when the jaw ridge gets too thin to place conventional implants. In this procedure, the bony ridge of the jaw is rebuilt by block grafting, tunneling procedures, or pocketing techniques. Bone graft material can be placed and must mature for a few months prior to implant placement.
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone used can be of either the particle or block type. It is obtained either from a tissue bank or your own bone taken from the jaw. 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 and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.
Sinus Lift Bone Graft
The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus floor is very thin, it is impossible to place dental implants in this bone.
There is a solution and its called a sinus graft or sinus lift graft. The dental implant surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted onto the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After a few months of healing, the bone becomes part of the patients jaw and dental implants can be inserted and stabilized in this new sinus bone.
The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.
If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus bone graft and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus bone graft will have to be performed first, then the graft will have to mature for a few months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.