Grafting for preparation for implant placement
Ridge Augmentation (Bone Grafting)
Like most of our procedures, a ridge augmentation is performed under local anesthetic. There are a handful of sedation options to help keep you comfortable during the procedure, but we do have to get the site numb. Once the numbness kicks in, the procedure takes 30-45 minutes.
The gum tissue is elevated to expose the jaw, bone graft (most of the time cadaver tissue) is placed in the deficient area, the graft is covered with a barrier to keep things in place, and the gum tissue is repositioned over the grafted site. There are a few stitches that will be placed to keep the area closed. The sutures are typically removed after four weeks of healing time, but the grafted site will have to heal five to six months before we are able to place implants.
There will be some post-operative swelling and discomfort, but we will prescribe medications to help with those issues. Anytime we are working in the mouth, there are risks for infection. For that reason, we will typically give antibiotics as well.
Grafting with Tooth Extraction
If we have a tooth that needs to be removed, and we are planning to eventually replace the tooth with a dental implant, we often bone graft at the time of tooth removal. When a broken or non-restorable tooth is removed, there is a “hole” or “socket” that remains in the jaw bone. Once the tooth is extracted, the socket is filled with a bone graft material to help prevent loss of jaw bone as the site heals.
This procedure is one of the best ways to reduce the need for more invasive bone grafting procedures at a later date. The post-operative downtime following this procedure is relatively easy - most patients report only minor discomfort for a couple of days.
With the increase of dental implant procedures comes the increase in the need for sinus lifts. This procedure, also called sinus augmentation, can make placing dental implants for the upper back teeth possible. There are times patients do not have adequate bone support necessary for implants. A sinus lift helps by increasing the amount of bone in the upper back jaw area.
A CT scan is taken to evaluate the need for a sinus lift. This scan gives your periodontist a 3D image that will show exactly what will need to be done to facilitate implant placement for the upper back teeth. If a sinus lift is needed, typically it is done using a donated (cadaver) bone graft material.
The sinus lift procedure is performed under local anesthetic, and there are multiple sedation options. Once the area is numb, the soft tissue is elevated to expose the underlying bone. A small window is created into the sinus cavity, and bone graft material is placed. The overlying soft tissue is replaced and held together with a few stitches.
There are times implants can be placed at the same time as the sinus lift, but often times they are separate procedures. Our ability to place implants in conjunction with bone grafting is based on how much host bone is present. Typically, the bone grafts will need an average of five to six months healing time.
Although recovery from a sinus lift is typically not extremely difficult, most patients experience some discomfort during the process. There may be some swelling or light bleeding from your mouth or nose in the days after surgery. Blowing your nose and sneezing can move the bone graft material or loosen the stitches, so avoiding those behaviors is helpful. Medications that may be prescribed to help during recovery are pain medication, antibiotics, and anti-inflammatories.
A follow up appointment will be set for a few weeks after the procedure. Many times the stitches can be removed at this appointment.
Like any surgery, a sinus lift does come with potential risks.
- The primary risk is perforation of the skin lining on the inside of the sinus. Most times these perforations can be repaired immediately, but there are times we have to allow the body to heal for a few months before completing the sinus lift.
- Infections are rare, but can occur.
- There are times the bone graft does not properly heal due to lack of blood supply (more often seen in smokers and uncontrolled diabetics)
- Inflammation of the sinus resulting in acute maxillary sinusitis
Periodontal/Bone Regeneration: Grafting to Save a Tooth
The progression of periodontal disease can lead to defects in the bone supporting the teeth. In certain situations, bone grafts can be used to regenerate the lost bone. In this procedure, the soft tissue is gently elevated to expose the underlying bone, the defect is thoroughly disinfected, the bone graft is placed, covered with a barrier, and the soft tissue is replaced. The degree of healthy bone regeneration varies between individuals, but we typically see significant improvements.