Procedures - Bone Grafting / PRP

Bone grafting

There are two elements that are required to place dental implants. There needs to be adequate bone height and width. Bone is very similar to muscle, if it is not stressed or in constant use it atrophies (decreases in size). Therefore, if teeth have been missing for a considerable amount of time, the bone tends to atrophy making placement of a dental implant difficult. However, by using technology such as platelet rich plasma (PRP), and new bone grafting techniques, bone can be grown in areas where it has resorbed. Making placement of dental implants possible. There are many different types of bone grafts as you can see by the following:

Ridge Preservation

This technique is used to maintain the bone width when a tooth is extracted. If a bone graft is placed at the time of tooth extraction, the ridge will maintain its width, making placement of an implant much easier. This increases the likelihood of success and the esthetic outcome is superior.

Ridge Augmentation

In most cases where there has been resorption of the ridge, an implant is able to be placed with a minor bone graft at the same time. This technique decreases the amount of healing time for the implant. However, in severe cases, the ridge as atrophied to the point that there is no room to place the implant. A bone graft is then necessary to increase the ridge width so an implant can be placed at a later date. To increase the ridge width many bone grafting techniques can be used. A bone graft can be obtained from the patient, or from a cadaver, and depends on the amount and type of bone required to restore the ridge width. The grafts can be as simple as a small graft from the oral cavity, to a lateral knee (tibia), and even a hip graft (iliac crest). Also in many situations cadaver bone can be used and mixed with PRP with outstanding results. This prevents the patient from having to undergo an additional bone harvesting procedure.

Sinus Lift Procedure

In certain patients, the maxillary sinuses are very large. These sinuses are located in the back of the upper jaw and are air filled cavities. An X-ray will show the doctor how large the maxillary sinuses actually are in the upper jaw. If the sinuses are so large to the point that there is no bone in the upper jaw, dental implants cannot be placed. To place dental implants in the upper jaw, the patient will need to undergo a sinus lift procedure. This is performed while the patient is asleep and comfortable. An incision is made in the back of the upper jaw and the sinus is exposed. A window is made into the sinus and a bone graft is placed at the bottom of the sinus. The bone graft then matures for six months and then the dental implants can be placed. In certain situations, the implants can be placed at the same time of a sinus lift.

Nerve Repositioning

In rare situations the inferior alveolar nerve needs to be repositioned to placed dental implants. The inferior alveolar nerve gives feeling to the lower lip and teeth. In certain situations the position of the nerve prevents adequate placement of dental implants in the back part of the lower jaw. An oral and maxillofacial surgeon can remove the overlying bone and reposition the nerve so it is not damaged during implant placement. Once the implants are placed, the surgeon then lays the nerve back onto the implants and a bone graft is placed if required. There are many bone grafting options available. The surgeons at Utah Surgical Arts will discuss with you the options that are available and determine what treatment plan is best for you.

PRP (Platelet Rich Plasma)

PRP is the latest technology that used in conjunction with bone grafts. PRP is obtained by drawing the patient's blood and spinning it down to separate the platelets from the remaining portion of the blood. Platelets are the component of blood that makes the blood clot and releases many growth factors to help the body heal itself. Once the PRP is obtained, it is mixed with the bone graft. The PRP holds the bone graft into place and allows it to heal much faster with decreased amount of post operative pain.