Bone Grafting Procedures

Socket preservation

When a tooth is planned for extraction, bone graft can be placed at the time of removal to maintain the existing bone for a future implant, reducing the need for a separate ridge augmentation later. Grafting material is placed where the tooth was and covered with a barrier membrane, promoting the growth of your own bone and preparing the site to receive an implant.

Sinus lift

The maxillary sinuses are air-filled spaces above the upper back teeth. When upper molars or premolars are lost, the sinus tends to expand downward into the area of the missing teeth. A sinus lift surgically raises the floor of the sinus and places bone graft material that stimulates adequate bone growth for implants.

Sinus grafting can be a preliminary surgery that prepares the bone, or it can be performed at the same time as implant placement when there is enough bone to stabilize the implants during healing.

Two approaches are used. In the lateral window technique, access is gained through a small window in the bone; the sinus membrane is elevated and graft material is placed along the sinus floor. In the crestal technique, the sinus floor is raised only in the local area of the implant, typically for single implants with sufficient remaining bone height.

Ridge repair and augmentation

After extraction, bone typically shrinks both vertically and horizontally. Without the stimulation of tooth function, the alveolar ridge resorbs, leaving an indentation that creates cosmetic and functional problems. Sites where teeth have been missing for years often lack the bone volume for implants of adequate size.

Ridge augmentation rebuilds the lost bone. The gum is lifted to expose the defect, which is filled with bone or bone substitute and covered with a membrane for protected healing. These modifications greatly improve appearance and increase the chances of successful, long-lasting implants. Augmentation may be staged before implant placement, or performed simultaneously where conditions allow; healing may take up to six months.

Ridge expansion with piezosurgery

When the ridge is too narrow, it can be divided and gently wedged apart, creating space that is filled with new bone to restore an adequate width for implants. Dr. Vergoullis performs ridge expansion with an innovative piezotome technique, a topic on which he has conducted extensive research and lectures nationally and internationally.