Bone Reconstruction Prior To Implant Placement

Today there is an increasing amount of people who choose to have their teeth replaced with dental implants. In some cases the replacement is immediate meaning that once teeth are removed, during the same surgery implants are placed to replace those previous teeth. The advantage of replacing a tooth with an implant at the time of extraction is that the amount of bone loss at the site of extraction is greatly minimized.  However for most people the decision or option to have their teeth replaced comes long after their teeth were lost, and after years of wearing removable partials, dentures or having fixed bridges anchored to adjacent teeth. The problem often encountered in  such cases is that the bone in the area where the teeth have been missing shrinks and there is significant loss of volume and height making it challenging to place implants . A bone augmentation or reconstruction procedure is then necessary and occasionally must be done prior to and in preparation for implant placement, this is what is commonly called a bone graft.

When situations of bone loss or long term absence of teeth present themselves the first step is to obtain the proper information for accurate diagnosis. A clinical and ultra low radiation 3D X-ray is taken of the jaw to be treated, the x-ray unit we use in our practice is called a Cone Beam CT Scan (CBCT) and it provides an accurate view and analysis of the problem. The slide show below shows how by means of clinical pictures and  dental CT scan we are able not only to plan the volume of bone that needs to be augmented but also with a second scan assess the success of the bone graft.

A Comparative Study Of Mineralized Bone Allografts Versus Xenografts In Atrophic Human Maxillary Sinuses

The placement of dental implants in the posterior maxilla can sometimes be complicated due to the loss of bone below the maxillary sinuses. This is very common after maxillary molars have been lost or extracted and no bone preservation procedures provided at the time of extraction. Sinus graft/lift procedures are then necessary in order to create a proper foundation for implant placement. This article, published in June 2010 pp 47-60 in the Journal of Implant and Advanced Clinical Dentistry (www.JIACD.com)compares the amount of new bone formation and residual graft material when mineralized human dried bone (allografts) are used versus bovine bone (xenografts) are utilized to increase bone volume in maxillary sinus.  Sammy Noumbissi DDS MS

Clinical And Histologic Evaluation Of A Mineralized Bone Allograft (Puros) In Human Maxillary Sinuses

This study was conducted by Dr. Noumbissi in 2000 and published in the Journal od oral Implantology in 2005. This project was part of Dr. Noumbissi thesis project while in training in dental implantology at Loma Linda University’s Graduate Program in Implant Dentistry in California.

This evaluation of one 100% mineralized bone allograft was the first of  its kind and the results were groundbreaking. An allograft is bone harvested from another individual of the same species, that means in this case that the material used was human bone.This article  is often referenced in implant publications by other authors. It is also widely quoted by lecturers and speakers around the world.

Please follow this link to read the article: Noumbissi et al Article JOI

Clinical Histologic, Histomorphometric Evaluation of Mineralized Solvent-Dehydrated Bone Allograft (Puros) …

Ultrasonic Bone Surgery

WE ARE EXCITED TO OFFER ULTRASONIC BONE SURGERY TO OUR PATIENTS.

This state of the art technology is also commonly called Piezosurgery and it has revolutionized surgery in medicine and oral implant surgery. The Sonic Surgeon 300 is an ultrasonic surgery uses precisely controlled, three-dimensional ultrasonic vibrations to cut bone without damaging surrounding tissues; in other words surgical procedures can now be performed with minimal trauma to soft tissue (gums), sinus membrane or nerves. This means that loss of blood is greatly reduced, post surgery discomfort minimal and in some cases eliminated. The Ultrasonic bone surgery is used at our office for a great variety of clinical applications, including: sinus lift, ridge augmentation, bone grafting, bone harvesting, tooth extraction, root extraction, implant site preparation, implant placement with virtually no damage to soft-tissue and nerves. This is a great benefit to patients because its use allows for less inflammation and faster healing.

Guided Bone Regeneration & Bone Graft

GUIDED BONE REGENERATION IS THE PROCESS BY WHICH BONE IS REGENERATED IN A DEFICIENT PROSPECTIVE IMPLANT AREA AND IN SOME CASES AROUND A TOOTH THAT HAS LOST SOME BONE.

This method of bone augmentation requires not only the bone material (graft) but also a barrier membrane to exclude gum tissue from invading the slower forming bone. Therefore the bone materials used in this case must be carefully selected because they need to be conductive at the very least. In other words the graft material must allow and facilitate your own bone forming cells to migrate into the graft and allow or trigger (inductive) your bone forming cells to use it as a scaffold for new bone formation and deposition.

Bone Reconstruction

BONE RECONSTRUCTION IS NEEDED WHEN ADVANCED BONE LOSS HAS TAKEN PLACE.

The reasons range from very long term tooth loss, trauma, gunshot wounds and congenitally missing teeth. In such cases the most common method of reconstruction is the use in the outpatient office is by means of a bone block. This bone block can be your own or a sterile block obtained from a tissue bank.