Major and Minor Bone Grafting
Over time, a jawbone with missing teeth atrophies or is reabsorbed. This often leaves 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. At Northeast Oral Surgery and Dental Implant Center, our doctors have the ability to grow bone where it is needed. This helps patients so that they can have dental implants, which will restore their functionality and aesthetic appearance.
Major Bone Grafting
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum, protecting the bone graft and encouraging bone regeneration.
Major bone grafts are typically performed to repair defects of the jaws. Defects may arise as a result of traumatic injuries, tumor surgery or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different sites, depending on the size of the defect. The skull (cranium), hip (iliac crest) and lateral knee (tibia) are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.
Sinus Lift Procedure
The maxillary sinuses are located behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.
There is a solution called a sinus graft or sinus lift graft. Our doctors at Northeast Oral Surgery and Dental Implant Center have been surgically trained to enter the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted into the floor of the sinus (which is also the roof of the upper jaw). After several months of healing, the bone becomes part of the jaw. Dental implants can then be inserted into this new sinus bone making it possible for a wider range of patients to have dental implants.
Bone Grafting Overview
For a brief narrated overview of the bone grafting process, please click the image below. It will launch our educational MiniModule in a separate window that may answer some of your questions about bone grafting.
In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. The technique of ridge expansion is used to restore the lost bone dimension, when the jaw ridge gets too thin to place conventional implants. In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the dental implant.
The inferior alveolar nerve gives feeling to the lower lip and chin and may need to be moved in order to make room for placement of dental implants in the lower jaw. This procedure is limited to the lower jaw and is indicated when teeth are missing in the area of the two back molars and/or and second premolar, with the above-mentioned secondary condition. This procedure is considered aggressive since there is almost always some postoperative numbness of the lower lip and jaw area, so less aggressive options are always considered first (placement of blade implants, etc.). Nerve repositioning is typically performed in the hospital, under IV sedation or general anesthesia. After discharge, bed rest is recommended for one day with limited physical activity for one week.