For dental implants to be successful, the jawbone must have enough bone to support them. You may not have enough bone because of tooth loss from periodontal (gum) disease, injury or trauma, or a developmental defect. If your jaw is too short (up and down), too narrow (side to side), or both, you will need a procedure to add bone to your jaw before implants can be placed.
Bone augmentation is a term that is used to describe a variety of procedures that are used to "build" bone so that dental implants can be placed. These procedures typically involve grafting (adding) bone or bonelike materials to the jaw, and waiting for the grafted material to fuse with the existing bone over several months.
There are several different procedures that can be used for bone augmentation. The correct procedure will be selected depending on the type, location and number of implants to be used. If you need a bone graft, it is important that we discuss all of the options available to you.
After a bone-augmentation procedure, you usually wait 6 to 12 months before placing implants.
Most bone-augmentation procedures involve the use of bone grafts. The best material for a bone graft is your own bone, which most likely will come from your chin or ramus (the back part of your lower jaw). This procedure can be completed under a local anaesthetic.
Many people are missing several teeth and need several implants. If bone needs to be built up to support several implants, a lot more bone-graft material will be needed than if a single implant is being placed. If you are having several implants placed and choose to use your own bone for a bone-graft procedure, the bone probably will usually have to be taken from your hip. This type of procedure is done in the hospital under general anaesthesia, and requires an overnight stay.
In many cases rather than using natural bone grafts it is possible to use a range of biomaterials to plump out or fill in around an already inserted implant. These materials come from a variety of sources including bovine, human bone and synthetic materials. Careful consideration is given to the use of such materials and discussed on an individual basis, but they are a key asset in the treatment of these cases. Their use is termed Guided Bone or Guided Tissue Regeneration.
One type of bone-augmentation procedure, called a sinus augmentation or lift (elevation), increases the height of your upper jaw by filling part of your maxillary sinus (the area above your jaw on either side of your nose) with bone. This is done when there is not enough bone to allow implants to be placed in the back part of the upper jaw.
Following tooth removal the sinus spaces frequently increase in size and on some occasions in order to place implants in this area it is necessary to re position the sinus lining at a higher level. The sinus lining is raised by a bone graft or biomaterial being introduced into the void and allowed to form new bone. The implants can either be placed at the same time as the augmentation or at a suitable time after healing has taken place. This technique is an extremely predictable way of creating new bone and in the majority of cases can be done under a local anaesthetic at the practice.
After a bone-augmentation procedure, you will be given antibiotics, pain medication and an antibacterial mouthwash. You will be asked to avoid certain foods, and will be told how to avoid putting pressure on the area while it heals. If you wear a denture, you may not be able to wear it for a month or longer while the area heals. If you have natural teeth near the bone graft, your dentist may make a temporary removable bridge or denture to help protect the area.
The bone graft will take about 6 to 12 months to heal before dental implants can be placed. At that time if titanium screws have been used to anchor the bone block in place, they will be removed before the implant is placed.
The success rate for bone grafts in the jaws for the purpose of placing dental implants is very high. However, there is always a chance that the bone graft will fail, even if your own bone was used. Bone grafts are not rejected like organ transplants. When they fail, it is usually because of an infection or because the grafted bone wasn't stabilized and has come loose from your jaw. Dentists don't know why some bone grafts fail, but they do know that certain people such as those who smoke and those with certain medical conditions have a higher risk of graft failure than others.
A failed graft will be removed. Once the area has healed, it will be reassess before deciding to place a second graft.