Atrophy or lack of bone tissue is a very common problem in modern dentistry. In this case, bone grafting will be the only way out.
Indications for bone grafting
Dentists perform bone grafting in the following clinical cases
- Jaw injury.
- Traumatic tooth extraction.
- Prosthetics of several teeth at once.
- Inflammation in the bone resulting in bone loss.
- Implantation needs.
Implantation bone grafting is the most common procedure associated with implantation and is the most common reason for grafting.
Bone grafting during implantation
When a doctor tells a patient that he needs bone grafting for dental implants, "what is it and why is it needed" is a completely logical question that anyone can ask. If a lot of time has passed since you lost a tooth, then the bone tissue will definitely decrease.
Its dystrophy occurs because the tissue no longer experiences the load from the tooth, which means that the body believes that it is not necessary, andtissues begin to dissolve both in width and height.
And when installing an implant, it is necessary that the tissues tightly surround and hold it. By standards, a classic implant requires approximately 10 millimeters of bone in height and 3 millimeters on each side. If there is not enough tissue, then extensions should be carried out.
Types of bone grafts
To perform bone grafting, the patient needs to install a bone graft, which will eventually take root and replace the missing tissue. Grafts are of the following main types:
- Autogenous transplants. The bone for them is taken from the patient himself. As a rule, the bone block is extracted from the lower jaw, from the area behind the extreme molars. If the bone cannot be taken from there, then the bone tissue of the thigh is taken. Such a block takes root best, but you have to carry out an additional operation.
- Allogeneic transplants. They are obtained from human donors and then carefully selected and sterilized. As a result, the individual properties of the bone are lost, and it can easily be used as a block.
- Xenogenic transplants. Here the source of the material is cattle. The block is processed to be completely sterile and compatible with the human body.
- Alloplastic grafts. Completely artificial blocks that mimic the structure of the bone. After the operation, they gradually dissolve or become a support for the growth of a person's natural bone.
There are several different methods of bone grafting, because modern dentistry is constantly improving. As a result, more suitable methods can be applied in different clinical cases. There are really a lot of techniques, but only some are worth considering in detail.
Guided Bone Regeneration
Recently, guided bone regeneration has become quite popular - the implantation of special membranes compatible with the human body, which accelerate the formation of jaw bones. The membranes are made from special collagen fibers that are not rejected by the body and are sometimes impregnated with a compound that stimulates bone growth.
Membranes are either absorbable or non-absorbable, depending on how long the scaffold needs to be held.
After the membrane is implanted in the required place, the wound is sutured, and you have to wait for some time until the bone tissue grows. This process usually takes about six months.
Guided regeneration is also bone grafting for dental implants. You can see photos of the blocks used for regeneration below.
Sinus lift
Sinus lift is a specific bone grafting that increases the volume of bone grafting in the upper jaw by raising the bottom of the maxillary sinus.
Sinus lift is prescribed in the following clinical cases:
- If the patient has no pathologies in the area of operation.
- With no risk of complications.
At the same time, sinus lifting is contraindicated in a number of clinical cases:
- Permanent runny nose.
- Presence of multiple septa in the maxillary sinus.
- Polyps in the nose.
- Sinusitis.
- Problems and diseases affecting bone tissue.
- Nicotine addiction.
Some of the contraindications can be eliminated, and only after that the sinus lift can be performed directly.
Sinus lift is performed in two main ways:
- Open operation.
- Closed operation.
Open sinus lift is a complex procedure that is performed when a sufficiently large amount of bone is missing. It is carried out in several stages:
- The dentist makes a small incision in the lining of the outside of the sinus.
- The sinus mucosa is slightly raised.
- The void is filled with the material that will be used for building.
- The exfoliated mucosa is put in place and everything is sutured.
If the bone tissue lacks a little, no more than 2 millimeters, then a closed sinus lift can be performed. It is done like this:
- First of all, an incision is made in the jaw at the site of the planned implant placement.
- Then, with a special dental instrument, the doctor lifts the bottom of the maxillary sinus through this incision.
- Osteoplastic material is placed deep into the hole.
- Immediately after that, an implant is placed in the jaw.
Method of bone block grafting
Bone block grafting is done less frequently than regeneration or sinus lift, since it just involves the use of grafts and their long engraftment. Such a block is fastened in different ways, sometimes even with special titanium screws. Six months later, the block completely takes root, the titanium pins are pulled out and implantation can be carried out.
Bone block grafting is performed as follows:
- The gum is cut.
- A special tool splits and pushes apart bone tissue.
- An osteoplastic material is placed in the resulting cavity.
- The graft is fixed with titanium feints in natural bone tissue.
- All gaps are filled with a special crumb that stimulates the formation of bone tissue.
- A special membrane is applied to the graft.
Bone block grafting is usually done if it is necessary to increase not only the height, but also the width of the bone tissue in the jaw, or if there is a lot of bone tissue missing.
Bone grafting for dental implants: complications
As with any surgery, there may well be some complications with bone grafting prior to implantation. The reviews say that they are possible:
- Bleeding. In the first two hours after the procedure, slight bleeding is quite natural,however, if it continues all day, you should see a doctor.
- Pain and swelling. In the first 2-3 days, they are quite natural, they are removed with antibiotics and painkillers. If the pain only gets worse, it's best to see a doctor as well.
- Numbness of the jaw. If it lasts several hours, it may be a sign of nerve damage.
- Edema. If it makes breathing difficult and prevents you from opening your mouth, then urgent medical attention is needed.
Bone grafting for dental implants: reviews
In general, patients respond positively to bone grafting. Most often, guided bone regeneration and sinus lift are done. The only drawback, as many note, is the increase in the cost of the already expensive implantation, as well as the long period of bone healing. The second drawback is devoid of only a closed sinus lift. In any case, bone grafting is something that is best avoided, and the only way out is to place an implant immediately after losing a tooth.
