Bone Grafting & Sinus Lifts
At Dr. Todd Jones Periodontics and Implant Dentistry, our Victoria specialist may recommend bone grafting or a sinus lift in order to improve oral health or create a stable base for one or more dental implants.
What are Bone Grafting & Sinus Lifts?
The key to a successful and long-lasting dental implant is the quality and quantity of jawbone to which the implant will be attached. Bone grafting and sinus lifts (sinus augmentation) are excellent ways to replace lost bone tissue and encourage natural bone growth. These procedures are versatile and predictable procedures which fulfill a wide variety of functions.
Our periodontist may recommend a bone graft or sinus lift for you if you have experienced bone deterioration and wish to have a dental implant placed, if ridges have in the bone have occurred due to trauma or other causes, or if the inferior alveolar nerve requires movement to allow for the placement of implants.
Periodontal disease is the leading cause of bone loss in the oral cavity, though there are others such as ill-fitting dentures and facial trauma.
The bone grafting procedure is an excellent way to replace lost bone tissue and encourage natural bone growth. Bone grafting is a versatile and predictable procedure which fulfills a wide variety of functions.
A bone graft may be required to create a stable base for dental implant placement, to halt the progression of gum disease, or to make the smile appear more aesthetically pleasing.
Sinus Lift (Sinus Augmentation)
In the most common sinus augmentation technique, a tiny incision is made near the upper premolar or molar region to expose the jawbone. A small opening is cut into the bone and the membrane lining the sinus on the other side of the opening is gently pushed upward. The underlying space is filled with bone graft material and the incision is closed.
The bone which is used for this procedure may be from your own body or from a cadaver. Sometimes the dentist might use synthetic materials which can also stimulate bone formation. Sinus augmentation has been shown to increase the success of dental implant procedures.
Gum/bone tissue regeneration – A thin barrier (membrane) is placed below the gum line over the grafting material. This barrier creates enough space for healthy tissue to grow and separates the faster growing gum tissue from the slower growing fibres. This means that bone cells can migrate to the protected area and grow naturally.
Tissue stimulating proteins – Enamel matrix proteins occur during natural tooth development. Emdogain is a matrix protein product which is usually placed on the affected site before the gum is sutured. It mediates the formation of accellular cementum on the tooth which provides a foundation to allow periodontal attachment to occur. Tissue stimulating proteins help create lost support in areas affected by periodontal defects.
Platelet-rich growth factors – A high platelet concentration liquid can be used to create a blood clot at the site of a wound. It has recently been discovered that PRGF also stimulates bone growth – meaning a denser graft in a shorter time period.
Types of Bone Grafts
Autogenous Bone Graft – In this type of graft the bone is removed from elsewhere in the body and implanted in the mouth. Common donor sites for bone grafting include the iliac section of the pelvis, the chin and the posterior third molar areas of the jaw. If large amounts of bone need to be harvested, the hip or the shin bone (tibia) is generally used.
Allograft – Synthetic bone (manmade) can be created in the laboratory and used in the bone grafting procedure. Bone can also be obtained from a bone bank (cadaver bone).
Xenograft – This is the implantation of bovine (cow) bone. A xenograft is safe and has been used successfully; ample bone can be obtained, and a secondary donor site is not necessary.
The Bone Grafting Process
Bone grafting is a fairly simple procedure that can be performed under local anesthetic; however, if large amounts of bone area need to be grafted, general anesthetic may be required.
Initially, the grafting material needs to either be harvested or prepared for insertion. A small incision is made in the gum tissue and then gently separated from the bone. The bone grafting material is then placed at the affected site. The gum is sutured in place and a follow-up appointment will need to be made within 10 days to assess progress. Bone grafting is a highly successful treatment and a good base for further periodontal restorations.