Patients who have been missing a tooth or several teeth for an extended period of time may need to undergo a bone grafting procedure. When a tooth is lost and not replaced, the jaw bone begins to deteriorate, making it very difficult to perform some tooth replacement procedures, such as dental implant placement. Without enough bone present for the implant to attach itself to the jaw, the implant is often not stable enough to support the tooth crown, and future complications may arise. There are several different procedures that can be performed; the treatment that you receive will depend on your individual case and oral needs.
Bone graft material can be obtained from a variety of sources. If you are able to utilize your own bone, it will likely be taken from another area inside the mouth around the third molar in the upper or lower jaw. In some cases, bone from the chin, or from your hip or tibia may be used. If you are not a candidate to use your own bone, it can be obtained from a tissue bank, or a mineral bone substitute can be used.
In this procedure, small oral bone grafts are placed to fill an empty tooth socket after a tooth has been lost or extracted. The placement of this bone graft is fairly simple and usually does not involve an extensive recovery period. The bone graft combines with your natural bone for several weeks after the procedure and will provide a strong anchor for a replacement dental implant.
Sinus Lift Procedure
Everyone has maxillary sinuses behind their cheeks and above their upper teeth. These sinuses have nothing in them, and unfortunately, the bone that separates the mouth from the sinus cavity is usually very thin. It is often extremely difficult to replace a lost tooth in the upper jaw with dental implants because there is not enough bone present. To solve this problem, the surgical team at Greater Charlotte Oral and Facial Surgery can perform a sinus lift procedure in which the oral surgeon enters into the sinus cavity and lifts up the sinus membrane. A bone graft is placed below the membrane, which will integrate with the bone in the jaw over several months. Once the graft has fused, dental implants can be placed.
A ridge expansion, a more complex form of bone grafting, may be necessary when the alveolar ridge bone, a special type of bone surrounding and supporting teeth, begins to deteriorate or lose density due to natural breakdown. During ridge expansion, performed to widen or heighten the jaw to increase the bone density and have implants placed, the bony ridge of the jaw is split surgically and bone graft material is inserted into the space made.
In some cases, the inferior alveolar nerve, which runs along the lower jaw bone and gives sensation to the lower lip and chin, must be repositioned in order for dental implants to be placed. This is an issue only if the implant will be placed in the area of the back two molars or second premolar. During this procedure, a section of the lower jaw bone is removed to expose the nerve and slightly move it aside. Once the dental implant is placed, the nerve is released to its original position, and a bone graft is placed to refill the jaw area removed. As this is a very aggressive approach, other surgical options are often considered prior to taking this route.
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