Bone augmentation in dental implantation
Bone augmentation in dental implantation is performed in cases where material is not enough. What are the main features of such an operation, its benefits, indications and contraindications?
The causes of atrophy of bone tissue and its danger
There are several causes of atrophy of bone tissue. The main is the loss of the tooth. After a few months after his removal of the fabric is gradually reduced in size. A year later, her number is at its minimum.
Other causes of atrophy are the following:
- Inflammation in the periodontal tissues.
- Cysts on roots of teeth, purulent inflammation.
- Features of the anatomical structure of the jaw.
- Pathology of bone tissue.
- Congenital anomalies of the processes of formation of bones.
- Some of the actions of doctors. More recently, after removal of the tooth edge of the hole compressed. This led to the formation of a narrow ridge of bone. At this time, this practice is not used.
This condition has several complications:
- changes in the structure of the bones, leading to the fact that in place of an extracted tooth it is impossible to install a dental implant;
- often the patient changes the shape of the face and occur speech disorders;
- changing a person’s appearance;
- adjacent and opposite teeth are gradually shifted.
To install the implant due to atrophy. However, because of this the cost of all materials and work will inevitably increase. To avoid wasting by holding the prosthetic tooth. And this should be done as quickly as possible. Otherwise, the expert resorted to plastic bones.
What is bone grafting
The most common cause of small amounts of solid tissue is its atrophy. This phenomenon is often defined in the area of previously extracted teeth. After all, when even one tooth is lost, the fabric is not under load. Bone loss is fixed vertically and horizontally.
Such operations are among the most complex in oral surgery and related industries. Only a few experts know how to make them right. The complexity of such operations is due to the fact that the doctor has to recreate what’s already been started by natural processes. And the more I repeat it the doctor, the treatment will be the best.
Implantable design as accurately as possible to repeat the structure of bone tissue. It is necessary that she was surrounded by the same tissues as the normal tooth. If happened so that it was necessary to remove the tooth, the implant tissue should not be delayed for a long time. The most optimal period of time — 2-3 months. If this time is missed, then the patient will have to undergo complicated procedures to build.
Prolonged absence of a tooth, the bone gradually atrophies.
Way directional tissue renewal
This bone augmentation is now the most common. The doctor can effectively increase the required size of the jaw area. For the implementation of this procedure requires the use of the preparation of bone tissue for grafting. Often uses the following materials:
- synthetic hydroxyapatite;
- physiological material (usually derived from cattle);
- a bone chip (taken from the patient in those areas where it usually happens a lot).
The best results are obtained by the latter method. In this case, the risk of rejection sits material is minimal. Latest effective, but in this case, there is a high risk of virus infection.
On top of the bone material to be replanting, use membrane. After blending all patches sewn with a mucous. The membrane required for reliable isolation of the bone and protect it from leaching.
Sometimes the doctor uses a so-called combined method. Its essence consists in the splitting process using methods of the tissue regeneration and implantation.
After alveolar bone is splintered, propyl expanded and then implanted the tissue of the bone. All this is then covered with the membrane and carefully sutured.
Podsazhivanie bone block
Used for implantation of autogenous block. It is taken from the patient from other areas of the jaw. As a rule, it is best suited bottom. The unit is attached to the jaw bone using special elements for synthesis. Further it is covered with shavings and leather gidroksiapatit. Be sure all of this is superimposed on the membrane. Mucosa subjected to operation, be sure to is sutured tightly.
Note some disadvantages of this method of grafting:
- It is much more traumatic. With such an operation that virtually eliminates the simultaneous installation of implants. After plastic surgery it will be necessary to wait some time (usually several months) before you will be able to implant in the bone implants.
- The risk of complications. They are much more than in the aimed tissue recovery, so the experts give preference to the latter method.
Common complications of operations
We should not assume that bone grafting when implants are safe. Any method is associated with various complications. Moreover, their risk is markedly increased in the event of any deviations from the method of operation.
And guided bone regeneration, and replanting block the membrane can strip through the suture line. This usually leads to purulent infection of wounds. If the speed of the processes of formation of blood vessels is reduced, a rejection may occur earlier implantable unit. In this case, it requires the complete removal of previously implanted material. Re-plasty in such cases almost inevitable.
If you are using bone blocks, the possible loss of its volume. Sometimes the degree of such loss is estimated more than 50%. This number is a re-surgery.
In addition, there can be a separation of the implanted unit, which has already taken root. This complication may be due to the fact that the unit is not fully integrated into the area of the jaw under the tooth implant.
What is sinus lift
Modern dental clinics offer their patients with the sinus lift. The essence of this procedure lies in the fact that a certain part of the bottom of the maxillary sinus is slightly shifted. The resulting space is filled with bone material.
Such lifting is closed and open. The first is used in cases when there is where to fix the primary implant. During open sinus lift procedure is an incision in the sinus wall. This method is preferable in cases where the quantity of bone tissue is not enough. Modern technologies allow us to successfully carry out such operations even in cases of severe deficiency of bone tissue.
Before you begin this procedure, the doctor examines the detail of the fabric. This is done to detect possible inflammatory processes, chronic diseases, complicating the operation. Sometimes the doctor can prevent, and some anatomical features. To conduct a survey is necessary and to determine the height of the fabric.
Preparation for surgery includes the following stages:
- Computer examination. Most often used computed tomography. It gives the most accurate data, as it allows to create a three-dimensional model of the jaw. This determines the volume of the maxillary sinus, is a computer simulation of a sinus lift. A detailed study helps to determine the amount of bone material needed for further action.
- This laboratory is developing a surgical template with the directions of the space for implants, guides and other parameters.
Only after a thorough preparatory work may be taken from the lifting. Modern technologies allow to significantly reduce the time of the recovery period. Usually, after 8-10 days, the doctor removes the stitch.
Implantation with the load
Erroneously it is called the basal. Specialist sets the material in the division of the jaw and bicortical plate type. Implantation with the holding of immediate loading will allow to do without necessarily increasing the missing tissues. Besides these departments of the jaw are the strongest. So you can do the installation of the implant without increasing tooth.
The stages of dental implantation without bone augmentation following:
- First, the bone and tissue of the piercing (in this case the incisions of considerable size are not done).
- Inside the bone, the doctor puts a prepared implant. The lower part it is fixed in the most deep and strong divisions of the jaw.
- The tip of the implant continues to rise above the gums.
- The implant is then fixed by a strong and at the same time, lightweight prosthesis, usually made of metalloplastmass.
The prosthesis itself is done after a short time, usually on the second or third day. An implant at such an early time is justified by the anatomical characteristics of the structure of the jaw. The usual load may be achieved by chewing. While in the tissue aktiviziruyutsya metabolic processes, it enters the blood. In this case, it is possible to achieve the fullest possible growth of the bone.
Surgery on the upper or lower jaw
Depending on the localization of bone loss and its subsequent extensions will be different. When the flow of this process on the part of the upper jaw may damage the maxillary sinus. This is especially noticeable in there, where are the molars. If you select the implants which will be much longer than the bones, may damage the sinuses. Solutions to this problem are:
- the procedure of sinus lifting;
- implant placement without increasing tissues.
Bone height should be not less than 10 cm Due to the individual approach of the modern hospital can establish qualitative materials, even if bone height is small.
Atrophy of bones of the lower jaw, the phenomenon of the reduction of its size is not crucial. However, the dentist may face the problem of closely spaced nerve. He can pass very close to the roots of the teeth. When nerve damage are possible complications:
- violations of the sensitivity of the lower part and even the entire face;
- numbness of the lips, tongue, cheeks;
- violation of pronunciation;
- disorders of swallowing.
On the lower jaw you can install the traditional implants. With possible immediate loading. Shown guided tissue regeneration, the installation or transplantation of a bone block and other interference.
Does the increase in conditionally removable prosthetics
Sometimes implants can install the light conditionally removable mechanisms. This is a simple and economical way to solve the problem of the missing tooth with atrophy of the tissue. It is sufficient to set a small number of implants. They fasten securely lightweight prosthesis.
The main function of these implants is to support dentures and not replace missing tooth roots. That is why such materials can be small. Established a two-part, one-piece design; in some cases can be used mini-implants. Selecting the correct design is always the dentist.
Today apply such methods conditionally removable prosthetics:
- beamed prosthetics;
- spherical prosthesis;
- push the prosthesis.
A removable prosthesis is much more comfortable and aesthetically pleasing for the patient. It does not cause inflammation or irritation, do not RUB the gums. Face shape and appearance are harmed by it.
What is included in the cost of the procedure
The final cost of augmentation and prosthetics will depend on the chosen methodology. The most expensive procedure with advanced bone grafting and subsequent restoration of teeth. In this case, the dentist uses expensive materials. The operation in such cases, costs a lot, too.
When restoring a small number of teeth, especially if used the classic Protocol, the service cost is much lower. However, the final cost will be calculated only after determining the amounts of all the necessary procedures and materials. In this sense, one-step restoration will be cheaper.
Conditionally removable dentures will be the most economical. This is due to the minimum quantity of materials necessary, especially if you will use cheap design of modern durable and lightweight materials.
Bone grafting is a complex procedure. However, it is a full-fledged resumption of the functions of the teeth and the digestive tract. Careful selection of equipment build will help avoid potential complications when performing this procedure.