Ridge Augmentation

Bone atrophy is a serious problem that occurs when a tooth is lost from periodontal disease, decay or trauma. When teeth are lost the bone begins to diminish in size and shrink away. Conventional bridgework and dentures cannot stop this phenomenon from occurring. Unesthetic cosmetic changes can occur with severe bone atrophy including the appearance of premature aging.

What Causes Jawbone Atrophy?

When natural teeth roots are present within the jawbone, they stimulate the bone by transmitting the normal stresses encountered during chewing. These stresses cause NORMAL bone turnover and this process preserves the existing bone structure. When teeth are lost or removed, the bone is no longer stimulated and bone resorption begins. Why? The jawbone then translates this lack of stimulation to mean it is no longer needed. As a result, bone atrophy occurs over time.
This is why individuals who have been missing teeth for a long time may have a gaunt or hollowed appearance. When dental implants are used to replace missing teeth, they actually mimic the natural roots. Therefore, the the jawbone is stimulated once again, preventing further bone loss in the future.

This is why individuals who have been missing teeth for a long time may have a gaunt or hollowed appearance. When dental implants are used to replace missing teeth, they actually mimic the natural roots. Therefore, the the jawbone is stimulated once again, preventing further bone loss in the future.

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The Importance of Healthy Bone

When it comes to dental implants, one common hurdle that many patients must overcome is bone loss. Dental implants can actively prevent bone loss from occurring in the future, but what about bone that has already been lost due to years of tooth loss?

In order for dental implants to be successful, they must be completed embedded in dense, healthy jawbone. Although this can be frustrating for patients who have experienced bone atrophy, there is a solution with jawbone regeneration.

Fortunately, almost everyone today are candidates for dental implants. Age is not a limiting factor except in some patient’s own minds. Health is a concern, but if you are healthy enough to have a tooth extracted then you are healthy enough to have dental implants placed. Diminished bone support has been a limiting factor in the past making implant placement difficult, unpredictable and even sometimes impossible. However, today we have many bone regeneration procedures that can correct a number of bone deficiency problems.

There are many types of bone grafting materials that have their pros and cons. Many surgeons use Bio-Oss. This bone graft material, Bio-Oss, with structure similar to human bone, not only supports new bone growth but also has been shown to preserve bone and overlying soft tissue following tooth removal. The Bio-Oss graft material is then covered with a natural fiber material, collagen, to protect both the graft and newly forming bone as well as to help support and help guide new soft tissue growth. Together, the Bio-Oss/Collagen system helps prevent bone and gum loss following tooth removal.

However the gold standard for any grafting material is either an autograft or an allograft. An autograft is bone taken from another site in your own body. Typically, Dr. Culley will use some autograft bone if it can be harvested from the site that is already having surgery. If not, another site must undergo surgery in order to get access to your own bone. This can be done, but it increases the chances of complications, increases the cost of additional surgery and increases your level of post-operative discomfort. We prefer to use allografts. An allograft is a type of bone graft that transplants bone from one person to another. In dentistry, this type of graft is often used to enhance an area of the mouth in preparation for dental implant placement. Allografts are taken from human cadaver tissue in a process that is highly regulated by the United States Food and Drug Administration and the American Association of Tissue Banks. Allografts are carefully processed to prevent any transmission of disease and are completely safe.

The type of graft used will depend on a number of factors including, but not limited to, the type of surgery being performed, your age, medical history, and bone quantity/quality. A prescription is required, and you should always consult your surgeon to understand which bone graft is right for you, as well as for a complete list of indications, warnings, precautions, adverse events, clinical results, and other important medical information.

Xenograft Tissue

Xenograft is bone taken from an animal source and transplanted into your body.

Benefits

  • Commonly used in surgery
  • Not human derived
  • Readily available
  • Well documented success
  • May heal small defects by itself
  • Portions of the graft may turn into your own bone

Drawbacks

  • Low risk of disease transmission
  • Does not stimulate your body’s cells to form bone
  • Portions of the graft may remain in your body for years to come
  • Limited in its ability to heal large defects by itself

Alloplast Bone Graft

Alloplast is synthetically made material to be used in your body as a bone graft alternative.

Benefits

  • Commonly used in surgery
  • Not human derived
  • Readily available
  • Well documented success
  • May heal small defects by itself
  • Portions of the graft may turn into your own bone
  • No risk for disease transmission

Drawbacks

  • Does not stimulate your body’s cells to form bone
  • Portions of the graft may remain in your body for years to come
  • Limited in its ability to heal large defects by itself

Autograft Tissue

Autograft is bone taken surgically from one part of your body and transplanted to another part.

Benefits

  • No potential for immune reaction or disease transmission
  • Commonly used in surgery
  • Well documented success
  • May heal large or small defects by itself
  • Transplanting your own bone forming cells to help heal the defect

Drawbacks

  • Risk of pain and/or infection at harvest site which may last for a long time
  • Additional surgery and anesthesia are required
  • May not be an option for some patients

Allograft Tissue

Allograft tissue is generously donated by the family of a deceased loved one to enhance the life of another individual.

Benefits

  • No potential for immune reaction or disease transmission
  • Commonly used in surgery
  • Well documented success
  • May heal small defects by itself
  • Most, if not all of the graft, will turn into your own bone

Drawbacks

  • Minimal risk for disease transmission*
  • Does not stimulate your body’s cells to form bone
  • Limited in its ability to heal large defects by itself

*Freeze-dried bone allograft (FDBA) and demineralized freeze-dried bone allograft (DFDBA) materials are widely used in periodontal therapy, and there are no reports of disease transmission during the 30-year history of using FDBA according to the Centers for Disease Control (CDC).

Ridge Augmentation for Dental Implants

Patients who are lacking adequate bone structure for dental implants can rebuild their jawbone with ridge augmentation. During this procedure, a bone grafting material is placed to add volume, height, and width to the bony ridge underneath the gums.

This procedure adds a few months to the total treatment timeline, as the bone must heal before implants can be placed. However, because dental implants offer a predictable long-term solution, most patients agree it is well worth the wait.

Ridge Augmentations can also be done to help rebuild jawbone for better fitting conventional denture, as well. Beyond that, often times jaw bone is regenerated for improved cosmetics under existing or new conventional fixed bridges to plump spaces giving a more esthetic appearance, prevent food impaction and improve phonetics.

Sinus Lifts for Dental Implants

Sinuses are air filled spaces in the upper jaw typically found behind the cuspids or eye teeth. Their size and position vary greatly from person to person. Sinus cavities typically get larger as we grow older or after back teeth have been lost. Today, sinuses can predictably be manipulated to allow bone grafting and implants to be placed. Typically this can be done at the time of implant placement, but in severe cases, separate procedures may be required.

We have the technology available to use your own bone for grafting called an “autograft,” or we can sometimes use synthetic bio engineered materials to reconstruct areas with diminished bone support. After thorough examination and diagnosis, Dr. Culley will recommend what options are available to you and the pros and cons of each.

Bone quality or quantity should no longer be viewed as a reason not to get dental implants. With the advances in bone grafting procedures, now almost everyone is a candidate for dental implants. If the sinuses are in the way, they can gently be moved and new bone grown in their place. If the nerve of the bottom jaw is in the way, techniques and technology are available to safely provide patients with tooth replacement therapy.