Additional procedures before Dental Implant Placement Dental implant placement in Borough Green, Sevenoaks
It is natural that after teeth have been removed the bone that once supported them slowly resorbs away. This occurs faster when prolonged gum problems have been present or poorly fitting dentures are being worn. The result is that there is sometimes not enough bone to support dental implants.
Bone Grafting
When there is not enough bone present, it may be necessary to create new bone to fill in missing areas allowing dental implants to be fitted. A variety of techniques are available to do this and they are referred to as bone grafting. The bone used in these situations can vary depending on how much we need to regenerate and where.
We often use sterilised particles of bone from either bovine (cow), porcine (pig) or deceased human bone origin. These are all sterilised thoroughly so there is no risk of cross contamination of diseases and they have the same rates of acceptance as your own bone.
We can collect your own bone from areas in the mouth where there is some spare.
In special cases where larger amounts of bone are needed, it is possible to move bone from other places such as the hip or shin to the deficient area of the mouth. The area from which the bone is taken will re-grow. This is not done very often now as the alternatives give less discomfort to the patient.
We can use bone substitute particles which act like your own bone and provide a scaffold for your own bone to grow into. Where clinical conditions indicate that bone-grafting is required to increase the amount of bone into which dental implants are placed it will generally increase the time taken to complete treatment. Under routine circumstances where no bone grafting is required the dental implants are commonly ready to begin function after three months later. If the bone grafting can be undertaken at the same time that dental implants are placed treatment is more likely to take six to twelve months. Where the dental implant placement must be delayed until after maturation of the bone graft, overall treatment may take twelve to eighteen months.
Socket Preservation
A technique called guided tissue regeneration has also shown considerable success where the amount of bone at the intended dental implant site is less than ideal. When a tooth is removed a hole in the gum and bone remains for the first few weeks. Anyone who has lost a tooth or had an extraction knows that this generally heals uneventfully, and eventually you cannot tell where the tooth was.
The basic principle behind ‘guided tissue regeneration’ is that placing a special membrane over the extraction socket creates a layer above which the fast-growing soft tissue cells are prevented from entering the bony socket. This allows bone cells present beneath the membrane the extra time they need to fill the socket without competition from soft tissues to occupy the same space.
Sinus Augmentation
It is very common to find that the softer bone on the area above the upper back teeth (molars and sometime premolars) is very shallow and not suitable for normal dental implant procedures. To solve this problem a procedure known as ‘sinus augmentation’ or ‘sinus lift’
was developed. Bone may be successfully grown in the sinus spaces above your upper back teeth allowing dental implants to be placed.
Synthetic bone substitutes, or bone from other areas of the mouth or body is placed into these empty areas. Over a period of time this is replaced by new bone thus providing a bed into which dental implants can be fixed. If the amount of bone overlying the sinus is adequate, some surgeons prefer to place the dental implants at the same time as the grafting procedures. Whatever type of bone is added to the sinus it must be left to mature before dental implants are placed or bought into function. If the dental implants are placed as a secondary procedure, (depending on the amount of bone being grown and the nature of the graft material used), they can be inserted after four to nine months, although occasionally it may be necessary to wait longer.
As with other bone grafting procedures, the dental implants are left to become firmly attached to the bone. Commonly a slightly extended healing period is chosen with an average of six to nine months before a denture or crown or bridgework is fitted.
However, all bone grafting is unique to each individual and this information is for guidance only.
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