Some people do not have enough healthy natural bone to support dental implants. Natural bone insufficiency can be caused by:
- Gum disease
- Tooth development defects
- Wearing dentures long term
- An injury to the face or trauma
- Spaces left empty in the mouth after teeth are removed
- Dental procedures where efforts were not made to restore natural bone
Several techniques are used to rebuild bone, restore your natural jaw line and smile, and provide a strong and sturdy foundation for implant-supported teeth. Most patients proceed with everyday life and work often by the next day and continue throughout the months in between dentist appointments.
Dr Elmanharawy will tell you if you need bone augmentation.
Below is an overview of some of the more common techniques to augment bone.
Bone grafting is a safe and highly successful procedure that involves the “building up” or adding bone to the jaw by using your own natural bone from another location and/or by using donor, processed or synthetic bone materials. Often the new bone can be obtained from inside the mouth. Ask your dental implant dentist about the advantages of different bone grafting methods and materials so that, together, you can make an informed decision.
Bone grafts are often performed in the implant dentist’s office using local anesthesia to numb the areas that will be involved, sometimes along with intravenous sedation to remove anxiety.
After the procedure, you will usually be given antibiotics, pain medication if needed, and an antibacterial mouthwash, and instructed to avoid eating certain foods and putting pressure on the bone graft. You will return home in between dentist appointments while the bone graft heals and should be able to work and go about your everyday life.
Your implants will be placed after the grafted bone has fused or become a strong, integrated part of the existing bone. The amount of time the integration takes varies depending on the location of the graft and the density of the bone. It may take three or more months.
Sinus Lift (Sinus Augmentation or Sinus Elevation).
Missing upper back teeth are among the most difficult to restore. When the back teeth in the upper jaw are missing the sinus cavity becomes larger as the natural bone deteriorates over time. A sinus lift, also called sinus augmentation or sinus elevation, is a bone-augmentation procedure for patients who have insufficient natural bone in this area for dental implant placement. The procedure involves adding bone below the sinus so that one or more implants can be placed. The procedure does not affect speech, intonation or cause sinus problems.
After the bone has been given time to develop, usually for approximately four to 12 months, dental implants can be placed. Sinus augmentation, which many patients say causes only minimal discomfort, is designed to help ensure that your implants are long-lasting, with ample, strong and sturdy bone that will allow your new teeth to fit and function like healthy, natural teeth.
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Ridge Expansion (Ridge Modification)
If the jaw isn’t wide enough to support dental implants, bone graft material can be added to a small ridge, or space, that is created along the top of the jaw. In some situations implants can be placed right after a ridge expansion. Other situations require approximately four to 12 months to ensure that the ridge has fully healed first. Like all bone grafting techniques, ridge expansion helps ensure a strong foundation and long lifespan for your new teeth. It also can be used to correct an unattractive and difficult-to-clean indentation that can occur in the jawline near missing teeth.
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Guided Bone Regeneration
For those who would prefer an easier, but slightly slower solution, there are other sources of bone specially prepared to make them safe for use in humans. All of these materials including your own bone, simply provide a scaffold into which new bone will grow and consolidate ready to receive dental implants a few months later. New bone can take anything from 3 to 12 months before it is ready to receive dental implants. Do not be in a hurry to move to the next stage. If you need a large volume of bone it will take longer to mature than a small amount. Guided tissue regeneration - Each surgeon will have his or her preferred way of creating new bone.
Many of them will also use a supplementary technique called ‘guided tissue regeneration’. Using this technique slow moving bone cells are given time to fill a space by placing a barrier material between them and the fast moving cells of the soft tissues lining the mouth. When this technique was originally developed the barrier material had to be removed during a separate surgical stage a few months later. Whilst these original materials are still in use, it is now more common to use a ‘resorbable barrier’ that will disappear naturally a few months after it has done its work.
Once a tooth is lost, the bone and gum will begin to recede. If you later decide to have an Implant fitted this bone recession may mean that the Implant would sit too high or the Crown would sit too low for your 'bite'.
A material can be inserted into the cavity to encourage bone re-growth. Over time, this will provide a sufficient amount of bone to support the Implant.