Over a period of time, the jawbone associated with missing teeth deteriorates in volume. Tooth infections and periodontal (gum) disease can also lead to bone loss. These often present a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In the past, these patients were not able to have dental implants. In essence, you do not want to build upon an unstable foundation.
Today, we have the ability to restore bone where needed. This not only gives us the opportunity to place implants of ideal size, but also gives us a chance to restore functionality and esthetic appearance.
The doctors at Sarasota Oral and Implant Surgery have completed extensive training in bone reconstruction and uses all available surgical techniques. These include using autologous bone (bone from the patient), allogeneic bone (sterile bone from another source), and BMP-2 (protein that creates new bone). They also utilize technology that extracts platelets and growth factors from a small blood draw. Not all cases are the same and our doctors believe in "the right firepower for the right fight". During your consultation, we will identify the most predictable and least invasive way to accomplish your goals.
Socket Preservation Grafting
Immediately following an extraction, the surrounding bone begins to resorb away if measures are not taken to prevent this. If you are even considering tooth replacement with a dental implant, Sarasota Oral and Implant Surgery can help optimize this area to preserve your options. Socket preservation grafting is a simple, painless procedure that can actually help prevent the need for additional surgeries in the future.
Minor Bone Grafting
In patients where only minor atrophy has occurred, placement of dental implants need not be delayed. The implant can often be place with very good stability and the mild bone defect grafted simultaneously. For minor grafts, autogenous bone (bone from the patient) or allogeneic bone (sterile bone from another source) are frequently used. Dr. Reuter and Dr. Thompson will discuss the advantages of each type of bone with you during your consultation.
Major Bone Grafting
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, infections, or injuries. Sinus bone grafts are also performed to replace bone in the posterior (back) upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. Platelets and growth factors can accelerate healing and increase successful bone growth. This is called guided bone regeneration or guided tissue regeneration.
Bone Morphogenetic Protein 2 (rhBMP-2) Bone Grafting
Bone Morphogenetic Protein (BMP) is naturally found in our bodies and helps with bone formation. Dr. Reuter is trained to use lab engineered BMP (rhBMP-2) to recruit the patient’s own stem cells for producing new bone. For some indications, BMP has the advantage in that it does not require an additional surgical procedure to harvest bone from the patient.
Platelet Rich Fibrin and Platelet Rich Plasma
A small blood draw from the patient can yield powerful growth factors. Our in-house lab spins down samples to collect platelets and growth factors that can significantly aid wound healing and bone formation. This simple procedure is used in conjunction with other grafting techniques to yield excellent results.
Sinus Lift Procedure
The maxillary sinuses are behind your cheeks and on top of the posterior upper teeth. 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 floor is very thin, it is impossible to place dental implants in this bone.
The solution is to create more bone with a sinus graft or sinus lift graft. The dental implant surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and graft is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.
Sinus grafting makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.
If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.