Bone tissue performs many tasks in the human body, including supporting and protective functions. As a support, bone is used to fix and hold internal organs and tissues during movement and at rest. As protection - bone is used in the form of cranial bones that protect the brain, or ribs that participate in the formation of the chest and protect the chest cavity, and even for the feeding process, when chewing food with teeth, bones are needed that form the upper and lower jaw, which contain teeth. Due to the fact that bone tissue forms the skeleton, ensuring the structural integrity of the body, it has a high regenerative potential, which is used, including in dentistry, for fractures and bone atrophy.

Bone tissue develops into bone from embryonic tissue - mesenchyme, with the help of such bone tissue cells as:

• osteoblasts (synthesize bone tissue)
• osteoclasts (dissolve bone tissue)
• osteocytes (keep bone tissue in balance)

These cells are formed from stem (undifferentiated, pluripotent) cells located near the blood capillaries.

Bone consists of outer compact (dense) bone areas, which enclose an inner spongy layer containing bone marrow located in the bone trabeculae (cells) of the spongy layer of bone tissue. On the outside, the bone is covered with periosteum containing blood vessels and nerve endings, which nourishes the bone and participates in the regeneration of bone tissue.

Bone tissue of the jaws

As everyone knows, the roots of the teeth are fixed in the bone tissue of the alveolar process of the jaws. The alveolar process is present on the upper and lower jaws. The height and thickness of the alveolar process is important for tooth retention. Normally, in the absence of diseases of the bone tissue of the jaws, which are caused by chronic inflammation of the gums, such as periodontitis, periodontitis, the height of the walls of the alveolar process is such that in the alveolar sockets, the roots of the teeth are covered with bone tissue up to the level of the neck of the tooth. This condition ensures the tooth's resistance to chewing loads and protects the tooth from loosening.

In addition to gum inflammation, the metabolism of jaw bone tissue is negatively affected by endocrine diseases such as diabetes mellitus and hyperthyroidism.

Chronic stress and constant lack of sleep also cause resorption (resorption and dissolution) of the jaw bone tissue. Atrophy of the jaw bones is also affected by tooth extraction, leading to dentition defects, and long-term use (more than 3 years) of removable dentures.

Many patients at the dentist say:

“Doctor, my teeth have come out of my bone.”

In fact, it was not the teeth that “started dancing,” but a loss (atrophy) of the jaw bone tissue of the alveolar process that occurred, leading to the exposure of the roots of the teeth. As the body ages, after 40 years, bone tissue mineralization begins to decrease, which also negatively affects the jaw bones. With the onset of menopause, women are at risk of developing systemic osteoporosis, the manifestations of which in the oral cavity also lead to the destruction of jaw bone tissue. Knowing this, dentists are making every effort to preserve the bone tissue of the jaws from atrophy processes, in order to preserve their own teeth.

In the absence of your own teeth, preserving the remaining volume of bone tissue is extremely important for implantation.

Bone Density

After 35-40 years, every person experiences negative changes in mineralization and bone density. In 2000, a direct connection was proven between a decrease in skeletal bone mineral density and a decrease in the height of the alveolar walls of the jaws in menopausal women. Thus, systemic osteoporosis, including that occurring after menopause, is a serious risk factor for the development of generalized periodontitis, leading to tooth loss and atrophy of the jaw bone tissue. Taking into account the fact that even with other favorable factors, after 35-40 years, a practically healthy person loses from 0.5 to 1% of bone mineral density every year, you can understand why it is necessary to check and take into account the condition of the jaw bone tissue.

The bone density of the jaws varies. In the upper jaw, the normal ratio of the compact layer of bone to the cancellous layer is approximately 1 to 3, and in the lower jaw it is approximately 1 to 1. This structure of bone tissue in the upper and lower jaws determines different possibilities and technologies for bone grafting necessary for dental implantation.

Bone tissue augmentation

Patients are often interested in: “In what cases is bone tissue augmentation required during dental implantation? How is bone grafting done during implantation?”

The growth of bone tissue for implantation depends on how the bone tissue takes root in the gum.

To build up the bone of the alveolar process of the jaws, the following factors are important:

• Careful removal of sources of infection from the oral cavity before the surgical stage, including removal of plaque and tartar, treatment of dental caries, removal of incurable tooth roots with cysts and granulomas, training in effective oral hygiene skills.
• Normalization and control of mineral metabolism, promoting mineralization of bone tissue. Curing or creating stable remission of hormonal diseases, such as diabetes, hyperthyroidism, hypothyroidism, hyperparathyroidism, correction of hormonal conditions during menopause in women.
• If bone tissue augmentation is carried out to preserve one’s own mobile teeth, then before reconstructive surgery, the teeth must be splinted and temporarily removed from the bite. If bone tissue is being built up for subsequent or simultaneous dental implantation, the choice of graft is important:

1. autograft (same patient undergoing surgery)
2. isograft (monozygotic, identical twin)
3. allograft (other person)
4. xenograft (animal)
5. combination of grafts (autograft + allograft)

• Carefully follow the doctor's recommendations in the postoperative period.
• To preserve newly created bone tissue in toothless areas of the jaw, it is necessary to carry out rational dental prosthetics supported by installed implants.

Bone grafting: types and methods

Bone grafting, what is it? In what cases is bone grafting performed during dental implantation?

Bone grafting of the jaw bones is performed in the following cases:

1. For gunshot and oncological lesions of the jaw bones.
2. After fractures and complex combined injuries of the jaw bones.
3. To preserve your own teeth and install dental implants in the jaw bones.

Complex volumetric operations in cases 1 and 2 are carried out in departments of maxillofacial surgery; in this article we will discuss the types and methods of bone grafting for installing dental implants and preserving one’s own teeth, which are performed in outpatient settings of dental clinics.

So, let’s roughly divide bone grafting, which is performed for:

1. Saving your own teeth
   And
2. Installation of dental implants.

Bone grafting to save teeth

Such methods are used in surgical periodontology. This type of treatment is aimed at restoring bone tissue around the roots of your own teeth. Plastic surgery and bone grafting depend on the degree of periodontal atrophy around the teeth. Such operations are fundamentally different from those that require bone grafting of the jaws to build up bone for implantation.

There are the following types of bone grafting to save teeth:

• Flap surgery with implantation of material to replace bone defects without a membrane.
• Flap surgery with implantation of material to replace bone defects with a membrane or, in other words, guided tissue regeneration. NTR.

Flap operations with implantation of material to replace bone defects without the use of membranes were carried out mainly until 1983. After the proven effectiveness of membranes, which stopped the penetration and apical migration of the gingival epithelium deep into the bone defect, and thereby contributed to the restoration of bone tissue around the roots of the teeth, today periodontal surgeons use directed tissue regeneration.

Guided tissue regeneration

The essence of the technique (clinical protocol for directed tissue regeneration in periodontology):

After tilting the gingival flap, the following is carried out:

1. final cleaning of the tooth root from plaque and stone with curettage (scraping) of the bone defect
2. biological modification of the bare root surface by treating the root with a solution of 30% citric acid (PH=1) or 37% phosphoric acid (PH=3)
3. introduction of a bone substitute into a bone defect
4. closure of a bone defect with an absorbable membrane
5. Return and suturing of the gingival flap.

The effectiveness of the technique is 65-70%, which is guaranteed to prolong the life of your own teeth after this type of operation.

Guided tissue regeneration in dentistry, video

Bone grafting for implant installation

Taking into account the fact that the main loss of bone tissue occurs in the lateral posterior parts of the upper and lower jaw, an operation called sinus lifting is used to restore the bone tissue of the upper jaw, which we will discuss in the next section, and the following methods are used to build bone in the lower jaw:

1. Transplantation of bone blocks taken from the patient himself from the chin area or the branch of the lower jaw
2. Replanting bone blocks consisting of preserved bone tissue from other people or animals.
3. Installation of an intraoral compression-distraction device (similar to the Ilizarov apparatus) to stimulate distraction osteogenesis.
4. If the height of the narrow ridge of the alveolar process allows for the installation of an implant, but there is not enough space in width, then splitting the ridge of the alveolar process is used with the simultaneous installation of implants without bone grafting, with the addition of tricalcium phosphate and xenogeneic bone filler such as "Bio-Oss".

Jaw bone grafting methods, which are performed to preserve natural teeth and to install implants, have a clear surgical protocol and all the necessary bone-active materials to achieve successful results.

Bone grafting for implantation, video

Sinus lifting

Sinus lifting is a dental surgical procedure on the upper jaw, which ultimately increases the volume of bone tissue of the lower wall of the maxillary sinus (in other words, the maxillary sinus) to a state in which dental implants can be inserted into this wall.

The alveolar process of the upper jaw, which is also the lower wall of the maxillary sinus, after the loss of the upper chewing teeth, decreases in volume quite quickly, especially with long-term wearing of a removable denture, and not from the side of the alveolar process of the oral cavity, but from the side of the maxillary sinus itself. This leads to pneumatization of the maxillary sinuses and, accordingly, a decrease in the height of the alveolar process.

The minimum height of the lower bone wall of the maxillary sinus, which is required when installing implants, is 10 mm. If there is no such height, then you have to carry out a sinus lift. With a minimum height of 3-4 mm of bone tissue remaining after atrophy of the lower wall of the maxillary sinus, it is possible to simultaneously perform a sinus lift with the installation of implants on the upper jaw. Sinus lifting lasts from 1 to 5 hours, depending on the complexity and the need for simultaneous implantation during sinus lifting.

The cost of bone grafting for dental implantation in Moscow depends on several points:

1. what type of bone augmentation is needed to install an implant?
2. consumption of necessary materials and medications
3. initial condition of the jaws

In Moscow, the turnkey price for bone augmentation for a dental implant starts from 20 - 30 thousand rubles.

Go straight to:

Osteoplasty or bone grafting for dental implantation is a surgical operation that is performed when there is a lack of bone in the upper or lower jaws.

The thickness of the bone at the site where dental implantation is performed is important. If there is a deficiency, the implant is placed deeper, so the risk of damage to blood vessels and nerve structures increases. Bone grafting during implantation is the only guaranteed way to recreate a normal anomaly. This is a solution for those who do not want implantation “for show”, but want to smile without embarrassment.

Increasing bone volume is carried out in several ways. The choice of surgical intervention lies with the dentist and maxillofacial surgeon, who comprehensively take into account all factors at once and settle on one option.

Types of bone grafting

• Splitting of the alveolar process. (We don't)
• Autograft transplantation (taken from the chin, hard palate or jaws). (We don't)
• Sinus lifting (performed when there is a threat of damage to the maxillary sinus with an implant of normal length, or in case of bone deficiency)
• Barrier membranes
• Guided regeneration technique.

The timing of graft engraftment with each technique additionally depends on the volume of plastic surgery. On average, you have to wait 3-6 months before implanting artificial roots.

When is it carried out?

Replenishment of bone deficiency in dentistry is carried out when conditions allow the installation of only a thin implant, which worsens the biomechanics of chewing.

Due to a host of factors, bone augmentation before implantation is the gold standard of treatment abroad. In Russia, operations are carried out less frequently than required by the rules. The Russian patient does not decide to undergo rehabilitation due to fears accumulated since childhood since the times of Soviet dentistry. Therefore, the installation of short implants without a guarantee, dentures and bridges is in full swing. And lack of thickness or height of the alveolar process is quite common.

Reasons for plastic surgery:

• The patient had a tooth removed a long time ago, due to which the bone had time to dissolve or become thinner. In this situation, the bone and gums become like a narrow comb.
• Congenital anatomical deficiency of bone tissue for installation of an implant of the required size. When immersed in bone tissue, a minimum of 2-3 mm of margin is required on both sides in order for the artificial root to hold.
• Lack of bone is possible not only in width, but also in height. There is then a risk of excessive immersion of the implant into the tissue or insufficient fixation.
• Inflammatory processes in the mouth that affect bone tissue lead to gradual thinning of the bone and gums.

If you ignore the problem and install an implant without bone grafting, it will gradually become exposed, be subject to angular overload during chewing, and spontaneous rejection will occur. In addition, after rejection in 100% of cases, accelerated bone atrophy occurs, and even greater loss of bone tissue is observed due to degenerative phenomena in it. To cope with the situation, volumetric bone grafting will have to be performed. This increases the risk of complications and the cost of treatment.

Features of preparation for surgery

The preparatory stage for surgical intervention begins with a comprehensive examination of the patient. The operation is performed under anesthesia (local or general). A number of laboratory tests determine the limitations of bone grafting or pain relief.

The standard diagnostic complex before surgical operations in patients with disabilities includes:

• clinical blood test;
• clinical urine analysis;
• biochemical blood parameters (coagulogram);
• consultation with a dentist-therapist;
• consultation with an anesthesiologist.

During the initial consultation, the council of doctors decides on the need for examination. Often the complexity of the operation is minimal and does not require such extensive examination.

Preparation is important for mature patients, who are sometimes unaware of concomitant chronic diseases that require correction before surgery. If the examination does not reveal any reasons for refusing the operation, then a date for bone grafting is set. A week before surgery, the patient takes intensive care of the oral cavity - thoroughly cleanses the teeth and rinses with chlorhexidine or another antiseptic. If dental plaque is present, preventative cleaning is prescribed.

One hour before surgery, do not eat. When performing general anesthesia, stop drinking 4-5 hours before.

Progress of surgery

The precise sequence of actions of the dental surgeon depends on the type of surgical procedure. The average plan is as follows:

• Access to the operated area of ​​the gum of the upper or lower jaw (alveolar process).
• Preparing the bed for transplant installation.
• Fixation of bone material or bone growth stimulator - immersion in tissue or placement of a special isolating barrier membrane (depending on the type of bone grafting).
• Installation of reinforcing barrier membranes (not required everywhere).
• Suturing soft tissues.

Then the graft engrafts and the formation of its own bone tissue occurs - this lasts six months. Healing times depend on the grafts used, the amount of bone grafting and the type of surgery.

Types of grafts

1. Autograft is your own bone tissue taken from areas of the body. (We don't)
2. Allograft is human bone tissue taken from cadavers. (We don't)
3. Xenograft - bone base, devoid of protein, tricalcium phosphate preparations, tissue of animal origin, regeneration stimulants;
4. Artificial bone tissue. (We don't)

We use only BMP technologies without transplanting patient bone blocks, without donor blocks. Only a pure procedure for stimulating your own bone tissue growth BMP with Geistlich or Cytoplast reinforcement.

All options have their advantages and disadvantages. Their use in clinics depends on the dental budget. Important:

• autotransplantation is traumatic for patients;
• allotransplantation - it is impossible to check the history of the source of the material for HIV and other viral components;
• xenotransplantation - gives the best results depending on the manufacturer. A graft implanted into spongy tissue full of blood vessels and biologically active substances takes root better and turns into your bone. Over time, it disappears and is replaced by the patient's bone.
• artificial blocks and synthetic materials are often rejected.

Rehabilitation period

The patient must be aware of possible complications and be able to distinguish normal from pathology. After surgery in our clinic you will receive:

1. informing about options for the condition after surgery;
2. a package with medicines and painkillers;
3. brochure about this period and recommendations.

Small traces of blood in saliva are normal in the first hours after plastic surgery. Saliva turns pale pink for another 5-6 days, but gradually becomes transparent. Bleeding time increases with physical activity, bending, if the patient was taking antiplatelet agents and anticoagulants (for example, aspirin) before surgery.

• The first three days - soft, delicate, crushed food.
• It is not recommended to drink drinks through a straw.
• To stop bleeding, hold cold water in your mouth, apply ice from a set to the operated area, or briefly press a clean finger.
• At night, the head is raised to prevent swelling of the face; it is better not to sleep on the side of the operation.
• In the first days, to combat pain, use analgesics prescribed by a doctor at least once every 6 hours. We will give you medicine with us.
• To relieve swelling (maximum manifestation after 1-2 days) - medications prescribed by a doctor, an ice pack wrapped in a towel. After 3 days, the swelling should subside, otherwise contact the clinic immediately.
• To prevent infection, use antibiotics and oral chlorhexidine baths. Do not actively rinse your mouth.

Constantly monitor the cleanliness of the operating area:

• For the first ten days, the operated areas are not cleaned. Clean your teeth with a soft toothbrush.
• It is recommended to use cotton swabs to remove food debris from the stitch area and periodically clean it. Tampons are moistened with Chlorhexedine.
• To speed up healing, a special dental ointment is applied to the sutures, which is prescribed and given to you by the doctor at the clinic.

It is prohibited to use folk remedies other than those approved by the doctor.

You should call our 24-hour support line for any questions or situations not listed in the post-operative instructions.

Patient reviews

Tamara Vladimirovna

I have contacted Vladimir Igorevich Strigin regarding the installation of bridges since 2016. The doctor works highly professionally, with minimal adjustments. Often one fitting is enough and the new bridges feel in the oral cavity almost like natural teeth, no discomfort or inconvenience! I am very pleased with the quality of Vladimir Igorevich’s work!

Consequences that are not complications:

• Formation of hematomas and bruises.
• Dryness and cracks in the corners of the lips and the occurrence of herpetic rashes, especially if there is a predisposition.
• The appearance of a sore throat and fever. If the fever progresses and does not subside within 3 days, consult a doctor immediately.
• Pain in the ears, neck, head, and areas of the mouth. Irradiation from the operated area goes away on its own.
• Increasing the reaction of teeth to changes in food temperature. It goes away 3-4 weeks after surgery.
• Feeling of increased tooth mobility 5-6 days after the procedure.
• Numbness of the jaws and skin, which lasts after the anesthesia wears off.

To avoid complications of plastic surgery, healing should be monitored by the surgeon. Two visits are required, one week apart. The patient is obliged to follow every doctor’s recommendation and avoid self-indulgence.

Is it possible to perform bone grafting simultaneously with implantation?

Yes, it is possible and it saves treatment time. Simultaneous plastic surgery with implant fixation is performed for minor bone deficiencies. Patients often require a one-stage procedure because they do not want to go through surgery again.

The patient must consent to such a treatment protocol if it becomes possible to implement it during the operation. This will require additional costs.

The decision to combine two manipulations is made exclusively by the doctor directly during the operation, assessing the risks and consequences.

Sincerely, Levin D.V., chief physician

Lack of bone volume in the area of ​​the dental defect is one of the most common relative contraindications to implantation. According to statistics, 70% of dental implants are installed in conditions of jawbone atrophy of varying severity. To solve this problem, many patients are prescribed one or another type of bone grafting.

Why is there a need for bone grafting?

The roots of natural teeth are located in the spongy part of the jawbone called the alveolar process. This area of ​​the jaw is riddled with blood vessels and nerves. The parameters of the alveolar processes are not constant values ​​and change under the influence of various factors - the intensity of the chewing load, traumatic tooth extraction, endocrine or systemic diseases of the joints and bones. Let's consider how the lack of chewing pressure affects the jawbone due to tooth extraction.

The roots of natural teeth, thanks to the constant chewing load, keep the alveolar processes in good shape. When one or more teeth are lost, the jawbone in the area of ​​the dentition defect ceases to experience pressure and gradually atrophies. Loss, or resorption, of bone begins several months after tooth extraction and can continue until the original volume is completely lost.

Depending on the location of the defect, bone tissue resorption occurs in different ways. Due to the fact that the density of the tubular bone in the upper jaw is several times lower than in the lower jaw, atrophy of the upper alveolar process occurs much faster. So, if in the lower jaw the process of bone shrinkage starts after 6-12 months, then in the upper jaw – already 2-3 months after tooth extraction.

Dentists distinguish the following types of bone atrophy:

• The alveolar process is reabsorbed across its width (horizontal atrophy).
• The alveolar process is absorbed in height (vertical atrophy).
• Resorption occurs in width and height simultaneously (combined atrophy).

Depending on the direction, degree and localization of resorption, various technologies are used to build up bone tissue for a dental implant. The chosen bone grafting technique, in turn, determines the type of osteoplastic material for bone augmentation.

Materials for bone tissue augmentation during implantation

In implantology, osteoplastic materials are used in the form of granules, bone blocks and porous membranes. There are osteoplastics of mineral (synthetic) and biogenic (animal) origin.

To build up the jawbone during implantation, the following types of bone material are used:

• Autogenous - a piece of bone extracted from the donor area of ​​the patient himself. The bone placed in the defect area is called an autograft.
• Allogeneic – the bone donor is another person. Allografts are taken in the event of a person's death, undergo special processing and are stored in donor tissue banks. Despite the ethical issues, allografts have a significant advantage, saving the patient from surgery to harvest his own bone tissue.
• Xenogeneic – material of animal origin based on bovine or pork bone. Used in the form of granules and bone blocks.
• Alloplastic - granules of synthetic origin based on calcium phosphate.

A separate group of osteoplastics consists of collagen membrane plates of animal origin. The main purpose of the membranes is to isolate the bone defect from the soft tissue of the gums and actively stimulate the repair of the jaw bone.

Types of bone grafting for dental implantation

To restore lost bone volume and install an implant, 4 technologies are used.

1. Splitting of the alveolar process

Description of technology: the alveolar process in the area of ​​the dental defect is sawed along the ridge with a dental cutter (1). The resulting hole is expanded with drills of different diameters (2,3), after which root-shaped implants are screwed in (4). The remaining cavities on both sides of the rods are filled with a synthetic or natural osteoplastic filler, covered with a resorbable membrane (5), and the gingival flap is sutured.

3-6 months after tissue regeneration is completed, abutments and temporary dental crowns are installed on the implants.

In the photo: Bone tissue augmentation before implantation by cutting the alveolar process

Indications: This bone grafting technology is used to restore several teeth with horizontal resorption of the alveolar process at least 2 mm thick.

Important: The method allows for bone grafting to be performed simultaneously with dental implantation, promotes rapid regeneration of bone tissue, and does not require surgery to collect autogenous bone material.

2. Bone block transplantation

Description of technology: the operation is carried out in two stages.

1. At the first stage, donor bone is collected from the chin area, from the cusps of missing wisdom teeth in the upper jaw, and in rare cases, from the ilium.
2. At the second stage, autogenous bone material is placed in the desired area of ​​the jaw using titanium screws. After this, the regenerated area is covered with a two-layer resorbable membrane and hidden under a gum flap.

Indications: restoration of one or more teeth with severe bone resorption in width or height.

Important: Using your own bone significantly increases the chances of successful regeneration of the implanted block. This type of bone grafting does not allow you to immediately proceed to implantation. The implant is installed only 6-12 months after the first operation.

3. Guided bone regeneration

Description of technology: (see the process in the photo below) The gums are opened (1), after which the area is injected with natural osteo-replacement material based on bovine bone (4). The area is covered with a two-layer collagen membrane (5) to guide bone regeneration and sutured (6). Instead of a resorbable membrane, a non-resorbable film on a titanium mesh frame can be used.

In the photo: Guided bone regeneration simultaneously with the installation of 2 implants

Indications: used for minor and moderate atrophy of bone tissue in width and height.

Important: the augmentation can be carried out simultaneously with the installation of the implant and does not require surgery to transplant a bone block.

4. Sinus lift

Description of technology: During the operation, the dental surgeon lifts the bottom of the maxillary sinus and fills the resulting cavity with a synthetic bone filler. Depending on how the manipulations to correct the bottom of the maxillary sinus are carried out, a distinction is made between closed and open sinus lift.

Indications: the upper jaw in the area of ​​5-7 chewing teeth with the close proximity of the maxillary sinuses.

Important: In most cases, implantation in the upper jaw is performed simultaneously with a sinus lift.

Prices for bone tissue augmentation during dental implantation in Moscow

The cost of the operation is determined by the following factors:

• Degree of bone tissue atrophy;
• Selected augmentation technology;
• Materials used.

A little about the cost of consumables:

Let's give an example of how the cost of augmenting bone tissue for an implant will change depending on the type of materials used.

* The membrane is used only in some cases.

We do not skimp on consumables, and to guarantee our clients the success of the operation, we use only experience-tested, expensive materials.

Cost of bone tissue augmentation for implantation at the NovaDent clinic

How to do without bone grafting

The NovaDent dental center offers clients several alternatives to bone grafting. To avoid complications and if there are appropriate indications, we can

Losing teeth can lead to very serious consequences, and therefore you should contact them promptly. Otherwise, bone loss and bone atrophy occur. Its cause can be considered the lack of load on the gums at the site of the missing tooth. upper jaw will help correct imperfections and give you a luxurious smile for many years. There can be many reasons for its implementation, ranging from periodontitis and ending with a banal jaw injury.

Typically, several procedures are used in the practice of such plastic surgery. Both regular bone grafting and one of its types, sinus lifting, can be performed here. The need for a specific procedure will be determined by your attending physician. However, for bone grafting of the upper jaw it is more typical.

The procedure got its name from the maxillary sinus, which is located in close proximity to the bone of the frontal part of the upper jaw. If you are planning to replace the loss of one of your front teeth with implantation, a sinus lift is the best, and sometimes the only, possible procedure that can restore the lack of bone above the implanted tooth.

Such an operation is necessary for the following reasons. Firstly, the height of the alveolar process in the upper jaw is often insufficient due to the natural structure of the upper jaw, and the risk of bone fracture due to its smaller thickness compared to the lower jaw increases during chewing. Secondly, reliable fixation of implants becomes impossible, because the implant must be completely immersed in the bone, without which the safety of the maxillary sinus cannot be guaranteed during implant installation. Fortunately, sinus lifting can solve such problems. Due to the fact that the maxillary sinus is naturally hollow, surgeons began to use it to create additional bone volume and height of the alveolar process in the area where the implant was installed in the upper jaw.

Maxillary bone grafting process

In a closed operation, the only difference is the material entry process. It is carried out not through the central canal, where the implant will subsequently be installed, but through small holes. Thus, the time for bone growth increases and reaches 3-6 months. The new bone is not rejected by the body, since it completely matches the structure of the person’s own bone.

Depending on the indications and characteristics of the body, the implant is installed directly during the procedure or after complete restoration of the bone.

It should be noted that the reduced volume of the maxillary sinus does not in any way affect the patient’s health, his speech or the functions of the nasopharynx.

Patient behavior after surgery.

Since bone grafting is not a major procedure, it is still a surgical intervention, it is very important to follow the recommendations of your attending physician, which will prevent unwanted complications. Mainly, this includes rules for preventing any colds in the maxillary sinuses. It is also important to remember that immediately after surgery, patients are not recommended to dive or fly on an airplane. Additionally, it is prohibited to subject the body to significant physical activity or to smoke. Patients, as a rule, do not have to endure more serious restrictions or lifestyle changes after undergoing bone grafting of the upper jaw.

Materials used for bone grafting of the upper jaw:

1. Autografts are the safest material for surgery. In this case, the material is taken directly from the client’s bone. Typically, such borrowing affects the chin or lower jaw. Unfortunately, performing surgery with this type of material leads to increased pain for the patient.
2. Allografts are also human bone, only borrowed from another person. Such bone goes through several stages of cleaning and processing before entering the patient’s body.
3. Xenografts are based on material of animal origin. Cow bone is usually used.
4. Alloplasts are an artificial material that organically fits into human regenerative processes.

Statistics show that in 40% of cases when a tooth is lost, bone grafting becomes absolutely necessary. You should not delay visiting the dentist, since timely treatment will reduce the rate of tissue regeneration and implant installation. We will be happy to recreate your dazzling smile.

Update date: 05/06/2019

Date of publication: 04/30/2013

Before deciding on dental implantation, the doctor evaluates the volume of bone tissue. If there is a deficiency, a bone grafting operation is recommended, which often frightens the patient and forces him to refuse dental implantation altogether. What should you really be wary of when augmenting bone tissue and is it possible to do dental implantation without it? Are such operations really that scary and are they always necessary, says the implant surgeon at the White Clematis dentistry in Moscow.

The importance of bone grafting in dentistry

One of the main advantages of implantation over classical prosthetics is that it prevents bone loss in the area of ​​missing teeth. The jawbone constantly needs stimulation, which occurs as a result of the pressure exerted on it during the chewing process. However, after the loss of a tooth, the bone ceases to receive the proper load, as a result of which it begins to decrease. Conventional dentures cannot prevent bone tissue resorption, since they mainly put pressure on neighboring teeth, and not on the area of ​​​​the missing tooth. Only an implant can stop this natural process. During dental implantation, bone tissue receives the necessary load and does not lose volume, which allows you to avoid numerous negative health consequences and maintain the aesthetics of your smile. In case of prolonged absence of a tooth, as a result of which the jawbone has begun to atrophy, bone grafting comes to the rescue.

What is bone grafting for dental implants?

Bone grafting in dental implantology is the augmentation of bone tissue, which is often necessary to perform turnkey dental implantation. On average, 3 to 6 months after the loss of a tooth, the process of bone tissue atrophy begins at the site of its removal, due to the fact that the bone ceases to bear the load. This process reaches its peak after about a year, and if you do not contact an implantologist immediately after removing unhealthy teeth, there is a high probability that additional bone augmentation surgery will be required later. It should be noted that plastic surgery, even in situations where there is a lack of jaw bone tissue, is not always required and not for everyone. The decision on the need for it will be made by the doctor, based on the situation of the individual patient.

There are cases when the bone tissue in the place of a missing tooth remains unchanged for many years, but this is rather an exception to the rule. More often, quite pronounced bone atrophy and even tilting or displacement of teeth towards the defect are observed.

What types of bone grafting are there?

Bone grafting of the lower jaw in the lateral regions is necessary in case of a decrease in the height and width of the alveolar process and a reduction in the distance to the mandibular canal. Significant loss of bone volume in the lower jaw can result in a change from the normal bite to a mesial bite (where the lower jaw moves forward).

Bone grafting of the alveolar process of the upper jaw is associated with bone resorption and the formation of a thin and sharp alveolar ridge. The difficulties of plastic surgery in this area are associated with the task of achieving an optimal cosmetic result.

Bone grafting of the lateral sections of the upper jaw is called sinus lifting, since the maxillary sinuses, or sinuses, are located in this area. There are closed and open sinus lifts, and they differ in the way they penetrate the bone.

Make an appointment

right now!

Implantologist, Maxillofacial surgeon

What materials are used for bone grafting in dentistry?

Both natural and synthetic materials, which have similar capabilities for engraftment and replenishment of bone volume, can be used as a bone tissue implant. Synthetic materials are made based on hydroxyapatite or calcium phosphate. As a rule, they are produced in powder form and are successfully used in world practice.

Autogenic

For bone tissue augmentation, the best material is autogenous, that is, your own bone sections taken from the donor area. Such an area, as a rule, is the chin or the area of ​​the lower jaw in the area of ​​​​the wisdom teeth. An autogenous graft takes root better than others, but its use is associated with an additional operation to collect donor material.

Allotransplantation

In addition to autotransplantation, in some cases allotransplantation is used, when bone material is taken from another person who bequeathed his organs for medical purposes. In this case, the donor material is carefully selected, sterilized and processed, and the recipient’s body eventually accepts such bone material as its own and successfully restores the lost bone.

Xenotransplantation

When people talk about xenotransplantation, they usually mean the transplantation of bone tissue from animals, usually cattle. The bones of cows and bulls are carefully processed, sterilized, and manipulated to make them compatible with the human body. Such transplants also take root well.

To adequately accomplish this task, we have developed and patented an original method of performing bone grafting in the oral cavity using bone material obtained from extraoral areas, which is the “gold standard” in world medicine. This allows us to subsequently install the required number of implants and subsequently carry out prosthetics of varying degrees of complexity.

What complications occur during bone grafting surgery?

Bone grafting in dental implantology varies greatly in complexity. This could be a major transplantation of bone blocks or some minor manipulation using osteoplastic material. But any operation requires the skill of a professional and his close attention to each patient individually. Any mistake in the bone tissue augmentation procedure is fraught with complications in the form of wound inflammation, suppuration or rejection of the bone block.

Many consider soft tissue swelling to be a complication after bone grafting. However, this is rather a natural reaction of the body to the surgical intervention. Swelling, as a rule, occurs and increases during the first two to three days, and then gradually subsides. Local hematomas may also appear.

Regardless of the volume of operations, all manipulations must be planned in such a way that the patient can endure them comfortably.

Is it possible to perform bone augmentation at the same time as dental implantation?

Of course, modern technology for dental implantation suggests that bone grafting of the jaw and installation of an implant can be carried out in one visit, but a lot in this matter depends on the clinical case and the doctor. For example, some specialists try to separate everything: first remove the tooth, then do bone grafting, and only after that carry out implantation. But what is it like for a patient to undergo surgery in the same place several times? Obviously, no one wants to experience this kind of stress. Therefore, bone grafting and implantation should be separated only in extreme cases, when bone tissue is missing in a sufficiently large volume. For the patient, of course, it is preferable to install an implant simultaneously with bone grafting of the jaw, but the decision on the order of the procedures must be made by the doctor, based on the specific case.

What prices can you expect for bone grafting in dentistry?

As a rule, the cost of bone grafting of the lower or upper jaw directly depends on the quantity and quality of the required bone material. Let's say, prices for a closed sinus lift in Moscow start from 15,000 rubles, for an open one - from 25,000 rubles, and taking your own bone material costs around 30,000 rubles. In White Clematis dentistry, the cost of this service is from 30,000 rubles. Each case is unique, and how much your bone grafting will cost will only be known at an appointment with a specialist.

Publisher: Expert magazine about dentistry website

Find out which clinic the doctor works at!