Guided Bone Regeneration
What is it?
Guided bone regeneration is a minor repair of the bone and is usually performed at the same time as the implant is being placed.
Human bone has the capacity to partially rebuild itself, but in some cases this process requires assistance. Biomaterials can support the body’s natural ability to regenerate lost bone.
The material is placed to act as a “biological space holder”. Initially, it mechanically prevents the collapse of the surrounding tissues. Then, through a process called “guided bone regeneration,” the human body is fooled to recognize the graft as natural bone and over time breaks it down to replace it with natural bone.
When is it needed?
– To support and augment the jaw bone when using dental implants, if the existing amount of bone is not sufficient for long-term stable implant anchoring.
– Repair defects around previously placed dental implants.
– Extensive bone damage; bone reconstruction after extensive bone loss.
The upper jaw has several qualities that make it unique to grafting as well as the placement of implants. The most significant difference in the upper jaw when compared to the lower jaw lies in the presence of the “maxillary sinus”.
The maxillary sinus is one of the several natural air spaces that are anatomically present in all human skulls. Its biological purpose is to warm, moisturize and filter air when we breathe. While the maxillary sinus is most often only noticed when one has a cold or infection, it can impose itself on the roots of the teeth in the upper jaw.
When a tooth is lost, the result may be the presence of very little bone between the oral cavity and this air space. In turn, this can make the placement of an implant in the back of the upper jaw a slightly bigger project when in comparison to other areas of the jaw. Fortunately, a relatively simple solution has been developed to handle this problem and render a safe, effective and stable result for placing implants.
The “sinus lift procedure” has been performed now for many years to allow implants to be used as a replacement for maxillary molars. It does not have an adverse effect on the sinuses.
The grafting procedure is performed by making a small window in the sinus above the roots of the upper jaw teeth. The integrity of the membrane lining the sinus is not violated but instead is teased upward to form a small cavity or balloon like space that can be filled with bone substitute (BioOss®LINK). A period of six to nine months is required for this bone to consolidate after having formed a scaffold for natural bone replacement, after which dental implants are placed.
BLOCK BONE GRAFTING
When is it required?
There are times when the bone defect size is too large for simultaneous guided bone regeneration (LINK). Conditions that will require an increased amount of bone to host a dental implant include the following;
Areas where teeth were removed and not replaced
An area where a tooth is missing and the nature of the disease associated with the tooth caused extensive bone destruction (i.e., infections).
Areas of the jaw where permanent teeth were congenitally missing and as a result, normal tooth supporting bone failed to develop.
Bone lost from dental trauma.
What does the procedure involve?
The procedure involves transferring a small block of bone from either the back of the mouth or at the front of the mouth to the future implant site. This is then secured with one or two tiny screws and overlaid with particulate bone (LINK) and a collagen membrane. The site is then securely closed and six months is usually given for the graft to fuse to the underlying jawbone before returning to the area to place an implant.
Once the graft is mature; the grafted bone will not only house an implant in “live” bone but it will also act to support the gum architecture in a manner that is both cosmetically pleasing and hygienically easy to maintain.
Bone grafting in the mouth today is a routine, predictable and painless procedure. It is done as a separate procedure before the implant is placed. The bone that has been transferred to the implant site will eventually grow back.
Is the procedure painful?
Pain is surprisingly low. Some bruising and swelling is to be expected for a few days after the procedure.
Gum Tissue Grafting
A gum graft may be necessary to protect your teeth from the damaging effects of gum recession, or you may choose to have it to improve the appearance of your smile.
A gum tissue graft also makes the gum around an implant look more natural and is important for front teeth implants.
Gum recession is the process in which the tissue that surrounds the teeth or implants pulls away from a tooth or a dental implant, exposing more of the tooth or the dental implant. This can cause damage to supporting bone and be painful when attempting to clean.
Gum recession is a common dental problem; it affects 4% to 12% of adults and often goes unnoticed until it becomes more severe.
Many people don’t even notice that their gums have receded, because it is a gradual process. An exposed tooth root can cause tooth sensitivity, especially when eating cold or hot foods. Untreated severe gum recession can eventually cause tooth loss.