Over a period of time, the jaw bone associated with missing teeth atrophies or is resorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.
We now have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance. The bone graft procedures are referred to as:
Distraction Osteogenisis
A new surgical procedure to "grow" deficient bone right where you need it, from existing jawbone. Is it a unique and precise procedure to create a foundation for implants without need for harvesting bone from the other areas of a patient's body (bone grafts).
Sinus Lift Procedure
This procedure involves elevating the sinus membrane and placing the bone graft onto the sinus floor, allowing implants to be placed in the back part of the upper jaw.
Ridge Augmentation
In some cases the alveolar ridge (that is the "housing" for the teeth) has resorbed and a bone graft is placed to increase the ridge height and/or width.
Nerve Repositioning
The inferior aveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in order to make room for placement of dental implants to the lower jaw.
These procedures may be performed separately or together, depending upon the individual's condition. There are several areas of the body which are suitable for attaining bone grafts.
In the maxillofacial region, bone grafts can be taken from inside the mouth, in the area of the chin or third molar region or in the upper jaw behind the last tooth. In more extensive situations, a greater quantity of bone can be attained from the hip or the outer aspect of the tibia at the knee.
The surgeries are performed in our office surgical suite usually under I.V. sedation or general anesthesia. After discharge, bed rest is recommended for one day and limited physical activity for one week.
Bone Morphogenic Protein (BMP) Graft- “INFUSE”
In dentistry, the primary indication for bone grafting has been the construction of a foundation in the jawbone for the insertion of dental implants. This foundation is an adequate amount of bone that is needed for dental implants to be placed into and eventually used as functional teeth.
Different traditional bone grafting materials, like bovine mineral and cadaveric bone, have been used for this purpose. It worked well in many cases but bone quality and quantity often remained an issue.
Recently, scientists and spinal surgeons have demonstrated that a genetically produced protein, recombinant human bone morphogenic protein-2 (rhBMP-2), has the ability to stimulate patient’s own cells to make more bone.
FDA has recently approved dental/oral use of INFUSE® bone graft for preservation of extraction sockets and augmentation of maxillary sinuses.
That was based on the clinical studies that showed a remarkable effect on bone formation for the placement of dental implants. The results were superior in bone quality and quantity in comparison with standard jawbone preservation techniques (bovine, cadaveric, ceramic, etc.).
This latest grafting material brought entirely new potentials for bone regeneration and healing in dentistry and oral surgery! In spite of the higher cost of the new graft, it can prove to be the most reliable bone grafting material so far.
Being on the forefront of innovations involved in oral surgery and implant dentistry, our office is now offering the INFUSE BMP bone grafting material for placement into sockets immediately after extraction of tooth or teeth (bone preservation), sinus augmentation and other cases of jawbone deficiency to aid insertion of dental implants.
If you questions regarding this or any other topics, please give us a call.
Van Ness Oral Surgery and Implantology Center
Dr. Len Tolstunov, DDS, DABOMS, DABOI/ID, DICOI, FAAOMS, FCALOMS
Assistant Clinical Professor, Department of Oral and Maxillofacial Surgery, UOP (Pacific) School of Dentistry
Founder and Director “The Implant Team” advanced implant seminars in San Francisco
