Major & Minor Bone Grafting
Over a period of time, areas of the jaw missing teeth shrink or are reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants without procedures to re-build the involved area.
Today, we have the ability to predictably grow bone in many areas of the jaws. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.
GRAFTING WITH GROWTH FACTORS
In the past decade reconstructive surgeons have been able to use solutions of growth factors to activate stem cells to become bone-growing cells. This has largely eliminated the need for older techniques involving bone harvesting, and hospitalization. Dr. Heggland has considerable expertise using these growth factors and has been part of select nationwide conferences regarding their use in reconstruction. These techniques allow Dr. Heggland to provide you with state of the art care unavailable in most other settings.
Major Bone Grafting
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a donor or your own bone is taken from the jaw, or other sites, depending on the size and nature of the needed reconstruction. Bone grafts are even performed into the sinuses to replace bone in the molar areas of the upper jaw. In addition, special membranes may be placed under the gum that dissolve over time but protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.
Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different sites depending on the size of the defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.
Sinus Lift Procedure
The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the upper teeth may 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 wall is very thin, it is impossible to place dental implants in this bone.
Fortunately, there is a solution and it’s called a sinus graft or sinus lift graft. Dr. Heggland enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone 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.
The sinus graft 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 well, sinus bone grafts 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.
In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. This is a technique used to restore the lost bone dimension when the jaw ridge gets too thin to place conventional implants. In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the implant.
The inferior alveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in order to make room for placement of dental implants in the lower jaw. This procedure is limited to the lower jaw and indicated when teeth are missing in the area of the two back molars and/or and second premolar. Typically, an outer section of the cheek side of the lower jawbone is removed in order to expose the nerve and vessel canal. Then we isolate the nerve and vessel bundle in that area and slightly pull it out to the side. At the same time, we will place the implants. Then the bundle is released and placed back over the implants. The surgical access is refilled with bone graft material of the surgeon’s choice and the area is closed.
These procedures may be performed separately or together, depending upon the individual’s condition. As stated earlier, there are several areas of the body that are suitable for attaining bone grafts. In the maxillofacial region, bone grafts can be taken from inside the mouth, in the area of the chin or lower wisdom tooth region, or in the upper jaw behind the last tooth. In more extensive situations, a greater quantity of bone can be attained from the hip or the outer aspect of the tibia at the knee.
In many cases, we can use allograft material to implement bone grafting for dental implants. This bone is prepared from donors and used to promote the patient’s own bone to grow into the repair site. It is quite effective and very safe. Synthetic materials can also be used to stimulate bone formation. We can even use commercially available growth factors derived from our own blood cells to accelerate and promote bone formation in graft areas.
Most of these surgeries are performed in the office-based surgery center surgical suite under IV sedation or general anesthesia, only some require hospitalization. After discharge, bed rest is sometimes recommended for one day and limited physical activity for one week.
Our Latest Patient Testimonial
I was on vacation in this area and had a dental emergency that required immediate attention so I am not a regular patient if Dr. Heggland. Everyone that I came in contact with at this office was extremely accommodating and cordial. I highly recommend Dr. Heggland and his staff!
Our Latest Patient Testimonial
I have a hard time with getting work done in the "dental" chair. It always gives me anxiety. I had to get a tooth pulled and it turned out I needed a bone graft as well. I can say that Dr. Heggland made me feel comfortable and made me forget my fears. He kept me informed of what was going to happen before it happened and made sure I was still content during the procedure. I couldn't believe how quick the transition was from getting the tooth pulled to the bone graft being completed. The communication between him and his team is astounding and made for the most comfortable appointment I've had in a very long time.
- Kathryn S
Our Latest Patient Testimonial
Wonderful office. Would highly recommend .
- Susan E