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In order for your dental implant procedure to be successful, there must be a sufficient amount of bone available to support your dental implant. In the cases where there is not enough bone, a bone grafting procedure may be performed in order to create a foundation for the dental implant.
A bone graft, or bone augmentation, is the process in which the bone is rebuilt or replaced by using bone or bone-like materials. There are several types of bone graft procedures including socket graft, lateral ridge graft, and sinus augmentation.
These procedures range from supplementing the existing bone to making complex changes to the size and shape of the dental ridge.
Bone loss can result over time from having missing teeth. However, it can also be caused by infection, trauma or periodontal disease. For patients that have been missing teeth for months or years, bone grafts are often required before a dental implant can be inserted.
There are 4 main sources that are commonly used for bone augmentation in a dental implant procedure. These sources are:
In certain cases, bone can be obtained from cadavers via a tissue bank. However, this method of grafting comes with risk as infectious diseases could be transmitted, in the same manner as receiving blood from a blood bank.
Cow bone has been used as a common option for obtaining the bone for a bone graft. It is processed and sterilized in order to minimize the chances of infection. However, like human cadaver bone, there is are still risks of infection and contamination.
Your Own Body
When using bone from your own body, there is no risk of tissue rejection, contamination or infectious disease. This would require an extra procedure to harvest the bone. Most commonly the bone is taken from the jawbone.
A synthetic bone-like material can be used and is the safest and least invasive option.
In order to determine if a bone graft procedure is required prior to the dental implant surgery, X-rays or a CT scan should be taken and analyzed.
Here are three types of bone graft procedures that are commonly use to help support the insertion of dental implants:
A socket graft is a simple bone graft procedure which must be performed at the same time when the tooth is extracted. It is good to preserve the bone at the site of the tooth extraction in order to prepare for the future dental implant procedure.
The socket graft is done immediately after the tooth extraction takes place in order to reduce post-extraction bone resorption and to preserve bone volume and the specific architecture of the site. By performing this procedure, it is less likely that a more complex bone graft procedure will be required at a later stage in the dental implant process.
Lateral Ridge Graft
When severe bone loss has resulted in a ridge that is too thin to support the dental implant, a lateral ridge graft may be performed. However, the bone height must be sufficient enough for the stabilization of the initial implant in order for this procedure to be successful.
During this procedure, the alveolar ridge is augmented by first cutting an opening. This creates a void in the center of the ridge, which is then filled with a bone graft material. This procedure is performed months in advance to ensure that there is sufficient blood supply to support the expanded bone and to give the bone graft time to undergo osseointegration, or fusion with the natural bone.
The sinuses are the open spaces behind your cheeks that are separate from the teeth. In some cases longer tooth roots of the upper teeth may extend into the sinuses. When the upper teeth are taken out, there is often just a thin layer of bone to separate the sinuses from the mouth. This thin layer may not be enough to support dental implants.
The solution to this problem is to perform a sinus lift. During this procedure, a small opening in the lateral sinus wall where the tooth extraction previously occurred is created. The sinus membrane is then exposed and lifted upward. A bone graft is inserted under the membrane into the sinus floor.
The bone graft is then allowed to heal for four to six months. When the bone is solid enough to support the dental implant, the dental implant is placed. In certain instances where the bone is only slightly deficient but the bone height is significant enough to support the dental implant, the sinus lift may be performed at the same time as the dental implant procedure.
For patients that lack sufficient bone, bone graft procedures make it possible for patients to receive dental implants in cases where their only options might have previously been dentures. Today’s advanced procedures mean that patients now have more options than ever for restoring their smiles.