Bone Grafting
Extraction and Immediate Bone Graft (Socket Graft)
The socket graft is extremely simple and an important procedure. This procedure must be accomplished at the time of tooth extraction. It helps to preserve bone at an extraction site in preparation for future implant placement. The area of the jaw bone that holds a tooth in place is called a tooth socket. Preservation of bone volume and architecture (shape) is crucial for implant stability and esthetics. After a tooth has been extracted, the supporting bone (socket) begins to rapidly melt away (bone resorption). Post-extraction bone resorption tends to be particularly severe in sockets with thin walls of bone. A socket preservation graft placed immediately after tooth extraction helps to preserve bone volume and architecture by minimizing post-extraction bone resorption. This procedure diminishes the likelihood that a more complicated bone graft will be necessary prior to implant placement. In many cases, this simple graft is all that is required to provide sufficient bone for implant placement. In some cases, due to severe inflammation at the extraction site, a low maxillary sinus, extensive preexisting bone loss and/or diseased tissue at the extraction site, it is not possible to provide enough bone volume for implant placement with this procedure alone. In these circumstances additional bone grafting may be required either at the time of implant placement, or as a staged procedure prior to implant placement.
The tooth is extracted with great care leaving as much socket bone intact as possible. After the tooth has been extracted, the socket is gently but thoroughly cleaned and debrided. A specially prepared particulate bone graft is inserted into the socket and retained by a suture over the socket. The site is reevaluated at one week then allowed to heal for several months. Once sufficient bone is present, the patient is ready to be scheduled for implant surgery.
If you require a tooth extraction and you are thinking of replacing the tooth with a dental implant, a consultation visit is strongly recommended prior to the extraction appointment so that Dr. Denny can determine the best way to proceed and inform you of all treatment options.
Ridge Modification Grafting
Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury or trauma. Not only does this deformity cause problems in placing the implant, it can also cause an unattractive indentation in the jaw line near the missing teeth that may be difficult to clean and maintain.
To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Dr. Denny can tell you about your options for graft materials, which can help to regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. In some instances the ridge may require several grafts to acquire an ideal result. Ridge modification can enhance your restorative success both esthetically and functionally.
Sinus Augmentation Bone Graft
A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you've lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.
Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. Dr. Denny can explain your options for graft materials, which can regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented.