Bone grafting and sinus lifting
One of the most important limitations that our specialists take into account when planning implantation is the amount of bone material in the area where the implant will be screwed in. Lack of bone tissue volume (atrophy) occurs as a result of prolonged absence of teeth (or individual anatomy), whereby the bone begins to atrophy immediately after tooth extraction, and each year the bone volume decreases by an average of 25%.
The task of bone grafting is to increase the volume of the jaw bone in order to fix the implant inside it securely. For this purpose, bone of different origin or its substitutes – special membranes are usually used. Unfortunately, bone augmentation delays the process of implant installation for 3-6 months, as bone tissue needs to survive and recover. However, with minimal presence of own bone, implant placement is possible during sinus lift surgery.
Bone grafting is an operation of restoring the volume of bone tissue. There are two types of operation - immediate with implantation and two-stage.
- Simultaneously with implantation, bone augmentation can be done only if the patient initially has enough bone for primary stabilization of the implant in the bone.
- In the case of a two-stage protocol, bone grafting is performed 6-8 months prior to the implantation. The very procedure of implantation follows only complete survival and dental prosthetics - in another 4-6 months.
A fragment of the patient's own bone or artificial, biocompatible components that do not cause rejection and allergies are usually used as a material for bone grafting.
There are several methods of bone grafting. The final choice of the method depends on the degree of bone atrophy, bone density, vertical height, etc.
This is a treatment that requires maximum cooperation between the doctor and the patient, as for the complete survival of the bone graft and subsequent successful implantation, the patient will need to follow all the instructions of his doctor carefully.
Sinus lifting is another option of bone grafting, but it is carried out on the upper jaw exclusively.
The task of this procedure is to move the area of the bottom of the maxillary sinus above its original level, and fill the formed empty space by bone biomaterial. Increasing the bone mass allows the use of long implants (more than 10 mm), it is sometimes necessary to create conditions for adequate resistance to occlusal load in the lateral parts of the jaw.
Sinus-lifting can be open and closed. The techniques differ in the method of integration of bone-substituting material into the maxillary sinus:
- Closed sinus lifting. Allows you to increase the height of the bone by only 3-4 mm. This is a less traumatic method, but it is carried out less often. The doctor cuts the gum in the place where the implant will be installed, creates a hole in the bone for it, and thus gets access to the sinus. A closed sinus lift is often combined with implantation.
- If the lack of bone tissue is more significant, we perform an open sinus lift. When the open sinus lift is performed, the surgeon must cut the gum and make a hollow in the jaw bone (like a window) to access the bottom of the sinus, through which he lifts the sinus mucosa and introduces the necessary amount of bone material. After that, the introduced biomaterial is isolated by a special membrane, and the gum is sutured. Further implantation is carried out only after the complete survival of bone material in 6-8 months.
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