Covid-19 & Safe Dental Treatment

Picture 1 3When a tooth is extracted or is naturally lost, the bone naturally degrades over time. It’s a natural process called resorption (or atrophy) and can result in severe bone loss within the jaw. The best thing to do to avoid bone loss is to replace a missing tooth immediately with an implant, but this is not always possible.

Bone grafting techniques encourage the bone to regenerate and replenish, either through adding bone regenerative material into the socket, adding bone grafts to the site if there is significant bone loss or adding a bone substitute.

Why are bone grafts necessary?

For us to place implants, we need plenty of bone in the jaw around it for it to have enough support. We always carry out accurate 3D scans and x-rays of your mouth before we use 3D computer aided diagnostic software to plan the placement of implants to achieve the highest possible surgical accuracy and precision. As part of this process, we often use 3D printed computer generated surgical guides developed by our in-house diagnosis and planning team.

Making sure that there is enough bone prevents issues later, such as a failing implant. We want to make sure that any implant we place will last a long time with no long term issues.

What does having a bone graft mean for my implant treatment?

While having a bone graft will ensure that your implant has plenty of support, it does mean that your treatment will take a bit longer. Bone grafts can take around a minimum of 12 weeks to fully generate healthy bone. In severely atrophic cases we may decide to wait up to 6 months after bone grafting before placing the implants. Each case is unique and we will discuss your treatment needs with you after carrying out a detailed clinical examination and appropriate tests and diagnostic imaging of your jaw first.

Bone Grafting

Sometimes people do not have enough bone to secure the implant. In these cases we need to carry out additional procedures to augment or rebuild the defect in the jawbone.

Bone shrinks after tooth loss due to a process known as “bone atrophy”. This is similar to muscle wasting. The bone shrinks because it’s no longer needed when teeth are lost. In order to fix dental implants adequate bone needs to be available within the jaw. When bone is missing or deficient, it can be rebuilt (regenerated) using bone augmentation or grafting procedures.

Bone augmentation

This may be done at the same time that the implant is placed (simultaneous bone augmentation), and it makes very little difference to the treatment or how long it takes. However if the bone is largely deficient then you may need a separate bone grafting procedure to regenerate (or rebuild) the bone as a first stage procedure. This can be carried out with bone substitute materials of synthetic, animal or human extract.

Localised Bone Regeneration or Guided Bone Regeneration (GBR)

There are many ways to regenerate bone. The most common and simple way is to create a scaffold into which new bone can grow. This can be done using bone regenerative materials of animal, synthetic or human origin. This is called Guided Bone Regeneration or localised bone augmentation.

The animal products are manufactured to US, European and UK standards and are safe to use in humans, however we will give you some specific information about the products that we plan to use when necessary.

Block Bone Grafting/ Reconstructive Bone Surgery

In some cases your own bone may need to be used if regeneration of larger volumes of bone is needed due to gross bone shrinkage or atrophy. In such cases bone may be collected from your lower or upper jaw or in more complex cases from the iliac crest (the hip bone). The latter is reserved for gross bone loss or major trauma cases such as road traffic accidents or oral cancer and requires hospital treatment.

Maxillary Sinus Grafting

A large cavity develops below the floor of the Maxillary sinus cavity towards the back of the upper jaw after tooth loss. This may prevent the fixation of the implant. A procedure known as Maxillary Sinus Grafting involves the filling of this cavity with bone regeneration materials in order to rebuild the lost bone. It takes approximately 6 months for the new bone to regenerate within the sinus cavity. Implant placement is deferred to allow the bone to “grow” first. Maxillary sinus grafting is a highly predictable and successful procedure.

Zygomatic implants offer an alternative to bone grafting and maxillary sinus grafting as usually they are used to by-pass the large sinus cavities and are fixed into the dense cortical bone of the base of the zygomatic bone within the cheek area. We will discuss all of these options with you if you are having a full jaw rehabilitation and suffer from severe case of bone shrinkage.

Socket Augmentation

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4 upper teeth are being extracted. Normally extraction sockets are left to heal in an “open” untreated fashion. With socket augmentation the extraction sockets are filled with bone substitute filler/graft materials mixed with Plasma PRF obtained from each patient’s own blood sample to enhance bone healing.
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Bone graft substitute is being injected into the extraction site
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Bone graft substitute is being injected into the extraction site
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Extraction sockets filled with bone substitute/filler materials at the time of the tooth removal
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Grafted socket is covered with a layer of plasma PRF to enhance healing
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The grafted socket is sutured before fitting a temporary denture. Implant placement is scheduled in approximately 8 to 10 weeks.
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