Bone Grafts
When a tooth is lost, bone resorption follows. Periodontitis and trauma can also cause resorption. Bone grafts are a treatment used to reconstruct lost bone volume through surgical techniques and biomaterials. This is an important guided bone regeneration (GBR) procedure required in simple, complex, or aesthetically demanding cases. Guided bone regeneration using biomaterials is a modern approach to restoring bone deficiencies, primarily using xenografts or allografts. The process is less invasive than in the past, as there is no longer a need for a second surgery to harvest bone from the patient. Thus, the advancement in technology and biomaterials ensures a predictable ridge reconstruction process in both simple and complex cases, with less pain and trauma for the patient.
Autografts
What is a bone autograft from the ramus or chin (Ramus/Chin graft)?
This type of graft is mainly indicated for vertical bone deficiencies when implants are to be placed, and the existing bone is deemed insufficient. Small blocks (pieces) are harvested intraorally from the chin or the ramus (angle) of the lower jaw in both cases. The bone blocks are stabilized in the recipient area with small titanium screws until the graft is integrated into the underlying bone (typically 3–4 months). Afterwards, the gums are sutured, and the graft is fully covered during the healing period.
When will you see me again after the graft?
Usually, the first follow-up visit after the procedure takes place 1 week to 10 days later, during which the sutures are removed, healing is checked, and the next appointment is scheduled—usually 3–5 months later—for implant placement. The waiting period is crucial, as any further delay may result in the bone graft starting to resorb again.
Sinus Lift
The sinus is located behind the cheeks and above the upper back teeth. It is often likened to an empty room. Some roots of the upper teeth protrude into the sinus cavity, and when the teeth are lost, a thin bone wall usually remains between the mouth and the sinus. Dental implants are placed in the bone, and when the bone beneath the sinus is insufficient, placement is impossible. The solution is a procedure known as a sinus lift. Entry into the sinus is made above the area where the teeth once were. The membrane is then lifted upward through the bone opening, and the bone graft is placed on the sinus floor, forming the new foundation for implant placement. The waiting time before placement is usually 3–8 months. If enough residual bone exists before the lift but the procedure is still deemed necessary, the implants and the lift can be performed simultaneously as a single procedure—either via an external approach (bone window opening) or an internal one (without opening a bone window).