The term “bone graft” sounds really scary, I know this, and
I feel for you. I’m going to share a little information about bone
grafting anyway. I’m going to try to show you that dental bone
grafting is a very good thing that helps make all kinds of other beautiful
dental related things possible. Let’s focus on the positive when it comes to
replacing bone for dental reasons. Here we go!
Little, Medium and Big Dental Bone Grafts
In the instance of a missing tooth or many missing teeth, a few things can
happen. First of all, it’s important to understand that your jaw bone is what holds your teeth in
place. The roots of your teeth are surrounded by bone and attached by
some other anatomical structures that we don’t really want to worry about
today.
If you are missing a tooth, you definitely want to replace
it with something, usually a dental implant or a bridge. Once a tooth is
removed, the bone doesn’t have anything to support anymore. Over time, it
begins to slowly erode until it creates a hollow or a basin shaped divot in the jaw bone. If
you try to place a bridge or a dental implant in a spot where the natural bone and gum tissue level is much lower than the surrounding
areas, it’s going to look kind of funny. A tooth in an area where the
bone level is very low is going to make you look really “long in the tooth”
(nobody wants that)!
The Little Bone Graft
In the case of a lost tooth, there are a couple of ways to
ensure that you will not lose excess bone height and width. Ideally, your dentist or oral
surgeon will remove the damaged tooth and preserve the bone in the area using a
simple bone grafting procedure. In this procedure, demineralized, sterile
human bone granules, (which look like coarse sand), are packed into the tooth
socket immediately after tooth extraction. The granules are covered with
a protective collagen membrane and a couple stitches are used to close the
tooth socket. This procedure is simple and usually does not add to your
recovery time. Over the next several weeks, your own bone will fill the
tooth socket and preserve the bone height long enough for you to have the area
restored. If you replace the missing tooth with a dental implant, the
bone level will remain indefinitely. If you replace the missing tooth
with a bridge, you will lose some of the bone level over time.
Medium Bone Grafts
If the tooth, or teeth were removed years ago, there is
likely some bone loss hindering the restoration of the area. A slightly more
involved bone graft may be needed. In this case, the area of the missing
tooth is opened with a small incision, the bone surface is prepared and
demineralized bone graft granules are used to build the area up. Many
surgeons prefer to use a little bit of the patient’s own bone in this procedure
in order to ensure the best results possible. If your own bone is used,
your surgeon will take it from another area of the jaw bone, usually near the
wisdom tooth area. He will not remove a large piece of bone, rather he
will shave off tiny granules and combine them with the demineralized
bone. Again, the graft is protected with a special membrane and sutures
are used to close it up tight. Over the next several months, the bone
graft will heal and integrate with the surrounding bone tissue, successfully
building up the width and height of the area so a nice restoration can be made. This type of graft can be used for one or
multiple areas of missing teeth.
Big Bone Graft
Sinus Lift Graft
Patients who have been missing many teeth for a very long
time have often experienced advanced bone loss which prevents adequate restoration of the teeth. In denture
wearers, the lower jaw bone often recedes so severely that their dentures no longer fit properly. The jaw bone in cases of advanced
bone loss can be as thin as a pencil in some patients. These patients can no longer wear a denture successfully and do not have enough
bone to place dental implants. Extensive bone grafting is necessary in
order to restore the missing teeth as well as restore quality of life. In
a procedure like this, a combination of demineralized, sterile human bone and
the patient’s own bone is used to build up the jaw bone, creating enough width and height to
accommodate dental implants. The patient’s bone is supplied by another
part of the jaw, hip or tibia in the form of a small block. This block is
anchored in place in the recipient site using specialized bone screws and
sometimes plates. Bone granules are used to enhance the graft. The
entire site is protected with a membrane, closed tightly with sutures and left
to heal for a period of months before dental implants can be placed in the new
bone.
The upper jaw has challenges of it’s own. Patients missing upper molar teeth often experience extensive
bone loss which causes the maxillary sinuses to become involved. The
maxillary sinus is a hollow cavity which sits just above the molars in the upper jaw. When these teeth have been
lost, the maxillary sinus often begins to dip down lower and lower.
Combined with bone loss from the missing teeth, patient’s can end up with just
an eggshell of bone between their gums and maxillary sinus. You cannot
place implants into a hollow cavity, so bone grafting is performed in order to
raise the floor of the sinus and increase the depth and width of the bone in
this area. This procedure is often referred to as “sinus lift”.
In the sinus lift, an incision is made in the gum tissue and
a small window is created into the maxillary sinus cavity. Very
carefully, the sinus membrane lining the sinus wall is detached and
lifted. Demineralized, sterile human bone and the patient’s own bone is combined and packed into the new
space between the sinus membrane and the bone of the sinus floor. Once
the desired thickness is achieved, a special collagen membrane is placed to
protect the new bone and the window and gum tissue is closed with
sutures. The width of the bone can also be augmented at this time in
order to increase bone width in preparation for dental implants. A graft
like this will need at least 4 months to heal before dental implants can be
placed in the new bone.
source: http://blog.texaswisdom.com/2012/08/all-about-dental-bone-grafting-its-not-as-scary-as-you-think/http://www.smilesbydesigninlivermore.com
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