Bone Grafting Procedures
Major & Minor Bone Grafting
Over a period of time, the bone in the upper jaw (maxilla) and lower jaw (mandible) will resorb if a tooth is missing or due to a tooth that was affected by an infection (periodontal disease). This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. To build back the bone, which is needed for an implant, we use use a variety of bone grafting techniques. This not only allows us the opportunity to place implants of proper length and width, but also gives us a chance to restore the tooth to its original function and aesthetic appearance. We have been using the following grafting procedures with great success.
The Bio-Col Technique
The Bio-Col technique is used immediately after a tooth or teeth are extracted. Usually, there is loss of soft tissue (gums) and bone around a tooth that had periodontal disease or has been infected for some time. Also, some extractions are difficult and require some bone to be removed to extract the entire tooth. Therefore, to replace the missing boen and to augment the bone to its natural and original state, we graft the socket and surrounding tissue with cadaver particulate bone immediately after the extraction. The bone is obtained from a bone back with the highest degree of sterilization and disinfection process available. The bone is in the form of particles which is placed directly within the socket. This technique not only augments the tissue but it preserves the normal contours of the bone and soft tissue. By during this very easy procedure, it prevents possible further bone loss which would require further augmentation surgical procedures. Also, the bone is more dense than the surrounding bone and provides greater implant success.
Dr. Burger has developed a technique using resorbable pins that are placed at the area that needs to be bone grafted. The pins hold the tissue away from the bone to allow the bone graft to heal. After five months, your own bone with replace the grafets bone. At this time the site will be ready for the implant.
The advantages of this technique are numerous. There is no need for another surgery to harvest bone from your jaw. There is not need to remove any material because the pins are resorbed after five months. There are less complications because there is only one surgical site and therefore less recovery time with minimal discomfort.
The Resorb-X foil panels are also used in larger areas of bone grafting especially in the upper (maxilla) jaw. The foil panels also resorb within five months.
Dr. Burger has been using this technique since 2008 with exceptional results both in the quality and quantity of bone. The procedure has been published in major scientific journals and presented to the Academy of Osseointegration.
The height of bone in the back part of the upper jaw is usually insufficient to place the appropriate implant length. Therefore, in order to increase the amount of bone, a bone graft is performed within the maxillary sinus. A small window is made along the side of the upper jaw, the membrane that lines the maxillary sinus is raised, and particulate or particle bone is added. The particle bone is cadaver bone which needs about five to six months of healing before placing the implant. Sometimes autogenous bone (your own bone) is harvested at the neighboring site and mixed with the cadaver bone. Also, platelet rich plasama is mixed with the bone graft to enhance bone growth and healing. Sometimes, if there is sufficient bone height to place the implant but not enough to cover the entire implant surface, the implant can be placed at the same time as the maxillary bone graft procedure.
Bioengineering research has found that platelets produce growth factors that can stimulate bone growth. This technique involves harvesting the patient’s platelets and mixing it with the bone graft. By using the plasma rich in platelets with the graft, the bone is greater in quality and quantity. Also, less time is needed for bone maturation.
Before the procedure, we obtain 50cc to 60cc of blood. The blood is centrifuged and the plasma rich in platelets is collected. This plasma is then mixed with the bone graft that is needed to augment the area for the future implant.
By using this techinque, we have found that the bone grafts are much better and the wounds heal quicker with less discomfort.