Bone Grafting
Over a period of time, the jawbone associated with missing teeth atrophies or shrinks. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, some patients are not candidates for placement of dental implants.

In most cases, we now have the ability to grow and replace bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance. Sufficient bone for these procedures can often be obtained quite comfortably from areas of the jaw adjacent to the deficient area. Alternatively, in many instances, bone substitute materials can be used. Some of the graft techniques performed in the office surgical setting include the following:

Socket Preservation
At the time a diseased tooth is removed, the bone at the extraction site can be maintained and even improved in terms of its volume and density by the addition of a processed mineral to the site. This graft of bone is packed into the site and then sealed off from the oral environment. Your bone over four to six months around the extraction site then replaces this graft and allows the formation of a good quality, dense bone for future implant placement.

Sinus Floor Augmentation "Sinus Lift"
When teeth are lost in the back of the upper jaw, the sinus above the roots of these teeth tends to expand downward and thins the available bone for implants in this area. This office procedure involves a small incision in the gums and a small opening into the floor of the sinus. This allows gentle elevation of the sinus membrane to its previous position and the placement of particulate bone grafting onto the sinus floor, thus permitting implants to be placed in these locations after adequate healing of 4 to 6 months.

Ridge Augmentation
In some cases where teeth have been missing for extended periods of time, the bony ridge where teeth used to be becomes too narrow and/or too short for implant placement. In these instances, small, carefully procedured and fitted grafts can be placed at the proposed implant sites to provide needed bone thickness and/or height.

Nerve-repositioning
In certain instances where inadequate bone height exists for implant placement in the back of the lower jaw, the inferior aveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in order to make room for placement of dental implants.

The above procedures may be performed separately or together, depending upon the individual's condition. There are several areas of the body which are suitable for obtaining bone grafts. In the maxillofacial region, bone grafts can be taken from inside the mouth, in the area of the chin or third molar region or in the upper jaw behind the last tooth. In more extensive situations, a greater quantity of bone can be obtained from the hip or the outer aspect of the tibia at the knee.

These surgeries are most-often performed in the office surgical suite under monitored I.V. sedation or general anesthesia. After discharge, bed rest is recommended for one day and limited physical activity for one week.

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