When a tooth is lost, bone resorption follows. Periodontitis and trauma can cause absorption. Bone grafts are a treatment for the reconstruction of lost bone mass through surgical techniques and biomaterials. This is an important process of guided regeneration-GBR that is required in complex or aesthetically demanding cases.
GBR (Guided Bone Regeneration)
Guided bone regeneration through biomaterials is a modern approach to restoring bone defects using mainly xenografts / allografts. The procedure is less invasive than in the past as no second surgery is performed to obtain a transplant from the patient himself. Therefore, the development of technology and biomaterials ensures a predictable process of bone reconstruction in simple or complex cases with less pain and trauma for the patient.
What is a bone graft from the angle of the ramus or from the chin (Ramus / Chin graft)?
This type of graft is suitable mainly for vertical bone defects when implants are to be placed and in case the existing bone is considered insufficient. Small blocks (pieces) are taken from the chin or the corner of the lower jaw intraorally in both cases.
The bone blocks are stabilized in the receiving area through small titanium screws until the graft is incorporated into the underlying bone (usually 3-4 months). The gums are then sutured and the graft is fully covered throughout the healing process.
When is my next appointment after the implant?
Usually the first visit after the operation is placed 1 week to 10 days later when the sutures are removed, the healing is checked and the next appointment is usually scheduled 3-5 months later for the implant placement. The waiting time is critical because in the event of further delay, the bone graft begins to be reabsorbed.
Sinus lift – Elevation of the sinus floor
The sinus is located behind the cheeks and above the back upper teeth. It looks like an empty room. Some roots of the upper teeth somehow penetrate the sinus and when they are lost there usually remains a thin bony wall separating the mouth and sinus. Dental implants are placed in the bone and when it is missing below the sinus, their placement is impossible. The solution is an operation known as sinus lift.
The entrance to the sinus is made above the point where the teeth used to be. The membrane is then raised upwards through the bone hole that is created and the bone graft is placed on the lower part of the sinus, resulting in a new bone formation for implant placement. The waiting time before installation is usually 3-8 months.
If there is some residual bone beforehand but the sinus lifting process is still necessary, implants and lifting can be done simultaneously as a single procedure with an external (opening a window) or an internal approach (without opening a window).
Normally, dentures should not be used after surgery because they push the graft, causing it to be absorbed or move . Of course, it is not realistic to avoid their use completely. Try not to wear them for 2 weeks after the operation. Dentures are then modified and a soft reline is placed internally so that the graft is not under any pressure during healing.