Bone augmentation is one of the most common ancillary procedures in dentistry. For decades, it has been the only way to place an implant in patients lacking jawbone volume. Now, when thin implants are made of ultra-strong materials, the technique is used less frequently but didn’t lose its relevance.
An artificial bone graft is necessary in case of the poor condition of the bone tissue, after injuries, surgeries, and tumors, as well as when factors make one-stage express implantation impossible. With the help of the surgery, it is possible to solve the issue of bone tissue deficiency and perform implantation in those patients to whom it was previously inaccessible.
What is Bone Augmentation?
Bone augmentation, also called bone grafting, is a surgical procedure. It involves the creation of an artificial cavity in the bone, into which osteoplastic material is grafted, or donor bone tissue is implanted. The methods of its implementation have their own characteristics, indications, and contraindications, but they lead to a single result – replenishment of the bone volume.
Why Does the Bone Disappear?
For the normal functioning of bone tissue, constant compression is necessary. It is absent in the place of the extracted or lost tooth. As a result, the tissues cease to be supplied with blood usually, their nutrition is insufficient, and the cells cease to divide actively to.
The bone starts a resorption process as early as 3 months after losing the tooth. The process affects the middle layer, which can lose volume in different directions. If it resorbs in height, implanting a standard implant 1 cm long will be impossible. If it resorbs in width, implanting a design of normal thickness will not be possible. In the most difficult cases, it resorbs both in height and width.
In different places of the oral cavity, resorption processes go unevenly. On the lower jaw, the width decreases faster, on the upper jaw, the height is first to decrease. The upper jaw is mostly prone to resorption in the bottom region of the maxillary sinus. Therefore, molars from above are the most difficult to replace with implants.
What Are the Methods of Bone Grafting?
The history of dentistry knows many ways to build bone back. Some of them have lost their relevance today. Others have been modified and are being used successfully. The choice is determined by the degree of bone tissue insufficiency, the location of the defect, and a number of other reasons.
The main methods of bone grafting are:
- Biomembrane after tooth extraction. The use of barrier membranes has a preventive value. Their goal is to prevent rapidly dividing soft tissue cells from occupying the cavity of the tooth socket after its extraction. In the cavity formed after dental extraction, osteoplastic material is placed and closed with a special membrane.
- Bone splitting. This method is used when the width of the alveolar ridge is insufficient. During the surgery, the bone is divided into two halves. At the end of the procedure, an osteoplastic mass is placed inside and, if necessary, implantation can be performed. A biomembrane is placed on top of the surgical site, the cavity is closed with a gum flap and sutured. Engraftment time takes around 3-6 months.
- Autotransplantation. Most often, this method is used after surgeries or injuries, when there is a significant lack of bone tissue. The essence of the technique is the transplantation of a small part of one’s own bone tissue into the jaw. Most often, the pelvic bone, the chin area, or the ends of the lower jaw are used for transplantation.
- Sinus lifting. A surgery during which the volume of tissues of the alveolar ridge of the upper jaw is restored. This is a necessary condition for implantation in the upper jaw since there is an increased risk of complications and low stabilization due to the closeness of the thinned bone to the bottom of the maxillary sinus. Sinus lift is performed by several methods and is more gentle than autotransplantation. Engraftment time is about 3-6 months.
- Osteoplasty with granules. This method involves the use of artificial material to restore the height of the bone. The operation proceeds with the opening of the gums, filling the holes with special granules, and closing the bone mass from above with a bioresorbable membrane. Implants can be placed on request, and then the gum is sutured. It engrafts in 6 months.
