Quite often, during the preparation for the implantation of teeth, patients are faced with a common problem - this is an insufficient amount of bone tissue or its atrophy. In such a situation, it is required to look for other methods for solving the problem, or the doctor prescribes a procedure for building up bone tissue.
How this happens, what are the reviews about the procedure and features, you will find out below.
Content
What to do with a small amount of bone tissue?
If the amount of tissue in the upper jaw is reduced, then there is a high risk of damage to the maxillary sinus. Implants in length exceed the bone, all this may increase the risk of rupture of the maxillary sinus and its infection occurs. The result is a chronic runny nose or sinusitis.
Problems with the upper jaw can be solved in this way:
- teeth are implanted without tissue buildup;
- a sinus lift operation is performed;
- for bone atrophy of the mandible, the doctor often faces the fact that the mandibular nerve is too close, and damage to it can lead to loss of linguistic sensitivity in whole or in part, lower face, and problems with pronunciation or swallowing.
And in order to perform the extension of the mandible bone tissue, the following is done:
- An implant is implanted into the anterior section of the jaw, but this extension is possible only in the presence of complete maxillary edentulous and is used to fix the prosthesis;
- the implant is placed next to the nerve;
- the position of the nerve changes;
- implantation of teeth is performed with we increase the tissue in the lower jaw.
Appointment of bone grafting
To implant a titanium construction, the fabric must have sufficient width and height. The stability of the position of the implant and the duration of its use depend on this.
If the patient has decided to perform implantation of teeth without the need for bone buildup, then the prerequisite is that the tissue should be at a maximum height of millimeters in height.
The indication for the bone extension procedure is small amount of fabric. In this case, the failure in each individual case is calculated individually. For example:
- if implantation is performed in the anterior maxillary section and the subsequent fixation of removable dentures is planned, then bone grafting is not required;
- if it is necessary to have a fixed prosthesis, and the bone tissue is not enough, then in this case, bone growth is required.
This plastic is a necessary measure also due to the fact that uncompensated bone atrophy leads to the following consequences:
- pathological displacement of the teeth, which can lead to their reeling and loss;
- facial expressions, articulation and speech are distorted;
- the chewing function is disturbed, which provokes problems with the digestive organs;
- facial contours are distorted, wrinkles appear and lips fall.
Therefore, bone grafting in case of atrophic changes in bone tissue is a vital necessity.
Methods of bone buildup
Thanks to modern technologies for the restoration of bone tissue can be implanted anywhere on the bone no matter what condition it is in. Now there are such methods of building as:
- bone regeneration;
- plastic;
- sinus lift;
- bone grafting.
Bone regeneration of directional type
During this procedure, bone grafting is performed in the form of a membrane, which has a high degree of bisability and helps to form bone tissue. Membrane do based on collagen fiber, it can dissolve and not dissolve. And after the membrane is implanted, the wounded surface is sutured. And only after the formation of bone tissue, implantation is carried out.
After a tooth is removed, a large hole remains in its place. And when they put an implant, in order to better fix it in the bone tissue, sometimes doctors use bone tissue.
Bone grafting and its application
But bone grafting is practiced less frequently. Bone escalated through graft in the following way:
- bone tissue sits down, it is taken from the lower jaw area (near the chin) or the upper wisdom teeth;
- the bone fragment after implantation is fixed with titanium screws;
- After about six months, the screws are removed and the implantation procedure is carried out.
- The procedure itself is as follows:
- the gum is cut;
- special tools bone tissue splits and moves apart;
- Osteoplastic material is immersed in the cavity;
- the graft is fixed with titanium screws;
- intermediate defects are filled with osteoplastic crumb;
- a membrane is applied, and the gum is sutured.
What is a sinus lift?
This concept implies increase in volumewhile raising the maxillary sinus. This technique of building up the dental tissue is used in such cases:
- in the absence of pathological phenomena in the place of the procedure;
- if the bone is present in a volume that meets the requirements for the procedure that is needed for the purpose of initial fixation of intraosseous implants;
- when there is no risk of complications during surgery.
- This operation is not prescribed when the patient has at least one contraindication. Among them are;
- a large number of partitions in the maxillary sinuses;
- chronic rhinitis;
- sinusitis;
- polyp;
- poor bone condition;
- if there is a history of operation on the maxillary sinuses;
- if the patient smokes a lot.
Sinus lift is divided into open and closed.
Open operation
The open-type surgery is quite complicated, and it is prescribed for severe bone failure on the sides of the maxilla. It runs like this:
- a small hole is made outside the wall of the sinus so that the mucous membrane is not affected;
- the mucous membrane is raised to the desired height;
- the resulting free space is filled with special material for building;
- partially fabric and mucous membrane, peeled off before, comes back and sewn up.
After some time, the desired amount of bone is formed, then implantation is performed.
Perform closed sinus lift
Such an operation is used during implantation, when there is no only 1-2 mm of bone tissue in height is enough. It includes the following steps:
- the bone bed is prepared for the implant - a hole is formed along its length, the maxillary sinus does not reach about 1-2 mm;
- using tools by lightly tapping, the remaining bone fragment is displaced deep into the sinus, thus the periosteal-mucosal flap rises;
- through the resulting hole into the bed material is introduced, then the implant itself is installed.
Pros and cons of sinus lifting
The advantages of this method of extension are:
- can restore tissue volume;
- using a closed type of operation, you can increase bone tissue with a minimum of injuries;
- You can get new teeth that fully replace real ones.
But if the operation was performed unsuccessfully, then, according to the reviews, such consequences can occur:
- the sinus is damaged, it in the future provokes the appearance of chronic rhinitis;
- the design falls into the maxillary sinus, so it will need to be removed;
- may develop inflammation in the sinus.
And the period after surgery and rehabilitation of the patient can take a very long time. The patient will need to comply with a number of requirements for a certain time, for example, not coughing or sneezing, so an implant or artificial bone may fall out.
After surgery is not recommended:
- eat hard, hot or cold;
- go to the sauna or bath;
- perform heavy physical exertion;
- dive;
- drink liquid through the tube;
- use air transport.
What is used when building
To restore lost bone volume apply a special graft. For this purpose, the following materials are used:
- autograft (the patient’s own tissue) - a section of tissue is taken from the maxillary chin area, maxillary outgrowths, rib cusps, upper jaw or ilium bone. The real bone takes root most quickly and successfully;
- allograft (donor tissue) - the donor in the extension is another person, most often a deceased person. Before setting the material, the bone is processed to prevent complications. Healing is slow because there are no viable cells;
- xenograft - animal tissue is used. It is more affordable than human. Substitution of material and bone resorption is extremely slow;
- Alloplast is an artificial material, for example, hydroxyapatite and its derivatives (bioceramics and others).
Reviews of the procedure
Now let's read real patient reviews about how they underwent bone building during implantation of teeth.
I decided to install two implants on the lower jaw. There is practically no bone tissue, since I have lost real teeth a long time ago, since I was already over 60. Before the implantation of the teeth, the doctor suggested that I should transplant bone blocks. After the procedure, swelling and bruising remained, they left in about a week. There was no particular discomfort. Implants instead of teeth, after bone engraftment, were given to me in about 2 months. And after a while, prosthetics were made using temporary crowns on the teeth.
I recently gave birth and after giving birth I lost two teeth that were on the lower jaw. The performed tomography showed that my bone volume would not allow the doctors to supply me with the desired size of artificial teeth. If they are too small in diameter, then osteoplasty is needed. Sometimes at the same time implantation of implants is required. After the procedure for some time it was unpleasant, there were swelling and blueness in the lower jaw. Dental implants took root in a couple of months, the doctor put the gum former. Very soon, the casts removed and put the crowns.
It was necessary to put artificial teeth and had to consult a doctor. It turned out that I needed a bone graft. A sinus lift is done on the upper jaw, and a bone is built up on the lower jaw. The discomfort lasted for about 10 days after the procedure, there were swelling and bruises on the face, I drank pills for pain. But after installing the implants and prosthetics, everything was settled.
Not in all cases, you can simply put implants instead of lost teeth. If there are problems, it is required pre-build bone tissue. How is this operation, we told in this material.