Following the loss of a tooth (or teeth), the supporting bone in the tooth socket area resorbs (shrinks). This often results in a shorter and/or thinner jaw ridge with a shape which is unsuitable for placement of dental implants. Unless corrective measures are taken, many patients may not be good candidates for the placement of dental implants.
Today, we have the ability to grow/maintain proper bone (jaw ridge) volume where it is needed.
This gives us the opportunity to predictably place implants and to restore both normal oral
function and an aesthetic appearance.
Bone grafting of the jaw ridge area repairs potential implant sites which have inadequate bone structure due to previous extractions, gum disease, cysts or injuries. The grafted bone may come from one of three sources: 1) autogenous bone from your own jaw ridge, chin or jaw ramus area- or - from your hip or knee area 2) tissue bank bone (sterile cadaver bone mineral) 3) Manufactured beta tri-calcium phosphate (Synthograft) bone mineral substitute. Protective collagen (connective tissue) membranes may be utilized beneath the gum tissue to contain and/ or protect the bone graft and encourage bone regeneration. Such membranes resorb in 6 - 8 weeks. This technique is called guided bone regeneration. Grafted bone becomes living bone in 3 - 6 months. It thus maintains the desired jaw ridge shape and is ultimately replaced by your own bone within 6 - 12 months.
The paired maxillary sinuses are natural hollow areas below the eye sockets above the upper posterior teeth. Sinuses are lined by mucous membranes which naturally moisten the nasal/sinus areas. They help to humidify the air we breathe. Oftentimes, the roots of the upper posterior teeth naturally extend up into or through the floor of the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone remaining in the jaw ridge which separates the maxillary sinus and the mouth. Dental implants require a certain height and width of bone to hold them securely in place. When the sinus floor is very thin, it is impossible to place dental implants in such deficient bone.
There is a corrective solution known as a sinus floor graft or a sinus lift graft. The surgeon enters the sinus from either the lateral wall or from the crest of the ridge. Dr. Perry uses the Piezosurgery Unit to perform such intricate surgeries. Piezosurgery employs ultrasonic technology to make very thin bone incisions and does not readily tear the delicate sinus membrane. Once the sinus is entered, the sinus membrane is then lifted upward and the bone graft is inserted into the floor area of the sinus. After ~ 6 months of healing, the grafted bone is normally mature enough for dental implants to be inserted and stabilized in this upper jaw ridge area. After bone healing occurs around the implants, they may then be restored with either fixed crowns and/or bridges, or with a removable partial denture or full denture. Dr. Perry was the first oral surgeon in Ohio to provide the Piezosurgery technology for his patients.
The unique Bicon short implants which Dr. Perry uses, can often be placed in the posterior upper jaw ridge areas without prior sinus floor grafting. These provide predictable long-term implant success in an area which is typically difficult to restore. Dr. Perry has used the unique Bicon implants since 1987.
If a minimum amount of bone height exists between the upper jaw ridge and the floor of the sinus to stabilize an implant, then sinus augmentations and implant placements can be performed as a single procedure. If not enough bone height is available to stabilize an implant, the sinus augmentation will have to be performed first, allowing the graft to mature for six months or more.
Once the graft healing is complete, then implant placement(s) may proceed. Sinus floor grafting now makes it possible for many patients to have dental implants where previously, there were no options other than to wear a removable and often loose denture.
Following the loss of teeth, the jaw ridge predictably will shrink in width, often making it impossible to place dental implants in such sites. Dr. Perry has designed his own osteotomes to aid in the expansion of such thin ridges so that implants may be placed.
Bone grafting materials and PRP (Platelet Rich Plasma) are normally employed in such situations. Dr. Perry has developed many techniques with Ridge Expansion & Grafts which avoid having to use a separate bone graft donor site. Most often, the dental implant(s) can be placed at the same time that ridge expansion and grafting is done.
The inferior alveolar nerve is the main sensory nerve in the lower jaw. It gives feeling to the lower lip and chin, gum and teeth. This nerve trunk may need to be moved off to the side (laterally) to make room for the placement of dental implants in the lower posterior jaw area.
This procedure is a more aggressive technique which is used to gain the height of bone necessary for the placement of implants. Such patients can normally expect some ostoperative numbness of the lower lip, chin and jaw area. Such loss of sensation may or may not ever return to normal. The use of Bicon short implants most often precludes the need to perform such risky procedures.
Most of our implant and/or grafting procedures are performed in our out-office surgical suite with local, IV sedation, &/or IV general anesthesia. Rest and more limited activities are recommended for the week after surgery.