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Bone Grafting
Over a period of time, the
jawbone associated with missing teeth atrophies or shrinks. This
often leaves an inadequate quantity of bone for implant
placement. Nearby structures such as the sinuses or nerves may
also interfere with implant placement. When these situations
occur reconstructing the jaw with bone grafts is often the
solution. Bone grafts can give us the opportunity to place
implants of the desired dimension in the best location to
restore function and esthetics. The bone graft procedures are
referred to as:
Socket
preservation
This method of grafting is
selected when significant bone loss is expected after tooth
extraction. It is intended to preserve the size and shape of the
jaw in the area of the tooth extraction thereby enabling future
implant placement. This is considered a minor degree of grafting
and is performed immediately after the tooth is removed. The
procedure involves placing bone grafting material into the
extraction socket to fill the socket completely. The socket
opening is then sealed with a dissolvable membrane or is closed
off with adjacent gum tissue. Four to six months of healing is
allowed before an implant is inserted into the area of the
graft.
Sinus grafting
In some people the maxillary
sinuses are large and can interfere with implant placement in
the upper back jaw region. This condition can be detected with
radiographs of the area. Sinus grafting can provide the correct
quantity of bone for implant placement.
The sinus graft is a common procedure and is usually
accomplished in the office under intravenous sedation or local
anesthesia. It involves elevating the existing sinus floor and
placing bone graft material into the area. In some cases,
implants may be inserted at the time of sinus grafting thereby
allowing simultaneous graft and implant healing. In situations
where there is less bone the implant placement may be delayed to
allow for graft healing. Once in place the graft, with or
without implants, it will need to heal for four to six months.
Onlay grafting
Smaller bone defects can be
corrected with the application of blocks of bone harvested from
the back part of the lower jaw or from the chin region. This is
an effective way to restore proper jaw form prior to implant
placement. It is usually performed in the office with local
anesthetic alone or in combination with intravenous sedation.
The usual healing time for this type of graft is approximately
four months. Harvesting bone from the jaw for grafting does not
weaken the jaw or change the facial appearance; in fact, the
bone usually regenerates at the harvest site after about six
months.
Major grafting
The amount of bone loss will
dictate how extensive the grafting will be. People who have
suffered extensive loss of bone from trauma, birth defects, or
long-term denture use are more likely to require major bone
grafting. Major grafting involving the reconstruction of an
entire dental arch may require harvesting bone from the hip and
transferring this bone to the jaw where it is secured in place
and allowed to heal. This technique requires hospitalization and
use of an operating room. An overnight stay is usually required.
The graft is allowed to heal for approximately four months
before implants can be inserted into the grafted bone. In most
cases, it is possible to continue use of some form of dental
prosthesis while the bone grafts and implants are healing
enabling continued esthetics and function throughout treatment.
Recovery
The recovery time after grafting
will depend on the type of graft performed. Socket preservation
may have as little as one day recovery while major grafting may
require one to two weeks. There will be some individual
variation which can be explained by your surgeon. Any dental
prosthesis to be worn is carefully adjusted to minimize any
irritation to the site of the graft. Patients are usually asked
to follow a soft diet. Healing times will vary depending on the
type of graft used and can range from three to nine months.
The Oral Facial Surgery Institute
has four convenient locations to meet your needs.
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