Bone plastic surgery for implantation of teeth: reviews
Atrophy or lack of bone tissue is a very common problem in modern dentistry. In this case, bone plastic will be the only way out of the situation.
Indications for bone plastic surgery
Dentists perform bone grafting in the following clinical cases.
- Jaw trauma.
- Traumatic tooth extraction.
- Prosthesis of several teeth at once.
- Inflammation in the bone, resulting in a decrease in bone tissue.
- Necessity of implantation.
Bone plasty during implantation is the most common implant-accompanying procedure, and most often plastic is performed precisely for this reason.
Bone plastic surgery for implantation of
When a doctor tells a patient that he needs bone plastic when implanting his teeth, "what it is and why it is needed" is a logical question that everyone can ask. If after you lost a tooth, it's been a long time, then the bone tissue must decrease.
Its dystrophy occurs because the load from the tooth does not already experience the tissue, which means that the body believes that it is not necessary, and the tissues begin to dissolve both in width and height.
And when installing the implant, it is necessary that the tissue is tightly surrounded and held. By standards, a classical implant requires approximately 10 millimeters of bone tissue in height and 3 millimeters on each side. If the tissue is not enough, then you should build up.
Types of bone grafts
For bone grafting, a patient needs to have a bone graft that will eventually settle down and replace the missing tissue. Transplants are of the following main types:
- Autogenous transplants. Bone for them is taken from the patient himself. As a rule, the bone block is extracted from the lower jaw, out of the area behind the extreme molars. If you can not take a bone from there, then the bone tissue of the hip is taken. This block is the most successful, but an additional operation is necessary.
- Allogeneic grafts. They are obtained from human donors, and then carefully selected and sterilized. As a result, the individual properties of the bone are lost, and it can easily be used as a block.
- Xenogenic transplants. Here the source of the material is cattle. The block is processed so as to become completely sterile and compatible with the human body.
- Alloplastic transplants. Completely artificial blocks that mimic the structure of the bone. After the operation, they gradually resolve or become a support for the growth of the human natural bone.
There are several different methods of bone plastic surgery, because modern dentistry is constantly being improved. As a result, more appropriate methods can be used in different clinical cases. The methodology is really very much, but only a few are worth considering in detail.
Directed bone regeneration
Recently, the directional bone regeneration has been very popular - the replanting of special membranes compatible with the human body, which accelerate the formation of the jaw bones. Membranes are made of special collagen fibers, which are not rejected by the body and are sometimes impregnated with a composition that stimulates the growth of bone tissue.
Membranes are resorbable and non-absorbable, depending on how long it takes to hold the frame.
After the membrane is implanted in the necessary place, the wound is sutured, and it takes a while to wait until the bone tissue grows. Usually this process takes about six months.
Directed regeneration is also bone plastic when implanting teeth. Photos of the blocks used for regeneration, you can see below.
Sinus-lifting is a specific bone plastic that increases the amount of bone plastic on the upper jaw due to the elevation of the bottom of the maxillary sinus.
Sinus-lifting is prescribed in the following clinical cases:
- If the patient has no pathologies in the operation area.
- If there is no risk of complications.
In this case, sinus lifting in a number of clinical cases is contraindicated:
- Constant rhinitis.
- Presence of multiple partitions in the maxillary sinus.
- Polyps in the nose.
- Problems and diseases affecting bone tissue.
- Dependence on nicotine.
Some of the contraindications can be eliminated, and only after this, carry out a sinus-lifting itself.
Sinus-lifting is carried out in two main ways:
- Open operation.
- Closed operation.
Open sine lifting is a complex procedure that is performed if a sufficiently large volume of bone tissue is lacking. It is carried out in several stages:
- The dentist slightly cuts the mucous outside of the sinus.
- The mucous tissue of the sinus slightly lifts.
- The void is filled with the material that will be used for building.
- The detached mucosa is put in place, and everything is sutured.
If the bone tissue does not reach a little, no more than 2 millimeters, then it is possible to conduct closed sinus-lifting. It is done like this:
- The first thing in the jaw at the site of the planned implant installation is an incision.
- Then a special dental instrument the doctor through this incision raises the bottom of the maxillary sinus.
- An osteoplastic material is laid deep into the hole.
- Immediately after this, an implant is placed in the jaw.
Bone block insertion method
Bone block replanting is less common than regeneration or sinus lifting, as it just implies the use of grafts and their long engraftment. Such a block is attached in various ways, sometimes even with special titanium screws. Six months later, the block is fully implanted, titanium pins are pulled out and implantation can be carried out.
Bone block replanting is performed as follows:
- Gums are cut.
- Special tool cleaves and spreads bone tissue.
- Osteoplastic material is placed in the cavity.
- The graft is fixed with titanium fint in natural bone tissue.
- All gaps are filled with special crumb, which stimulates the formation of bone tissue.
- A special membrane is applied to the transplant.
Bone block replanting is usually done if you need to increase not only the height, but also the width of the bone tissue in the jaw, or if there is very little bone tissue.
Bone plastic surgery for implantation of teeth: complications of
As with any operation, with bone plastication, some complications may arise before implantation. In the reviews it is said that the following are possible:
- Bleeding. In the first two hours after the procedure, a small bleeding is quite natural, but if it continues all day, then you should go to the doctor.
- Pain and swelling. In the first 2-3 days are quite natural, they are removed by antibiotics and painkillers. If the pain becomes only stronger, it is also better to visit the doctor.
- Numbness of the jaw. If it lasts for several hours, it can be a sign of nerve damage.
- Edema. If it makes breathing difficult and prevents opening your mouth, then urgent medical attention is needed.
Bone plastic for implantation of teeth: reviews of
In general, patients on osseous plastic respond positively. Most often, directional bone regeneration and sinus-lifting are done. The only drawback, as many have noted, is an increase in the cost of an already expensive implantation, as well as a long period of bone survival. The second disadvantage is deprived only closed sinus-lifting. In any case, bone plastic is what is best avoided, and the only way is to put the implant immediately after the tooth is lost.