Socket preservation
Before teeth are extracted, we could plan to place bone grafts at the time of the tooth removal to help maintain the existing bone so that an implant can be placed later. By doing this, we could reduce the need to perform a ridge augmentation as separate surgical treatment. This procedure is called “socket preservation”. Usually we place bone grafting material where the tooth was and cover it with a barrier membrane. This will promote the growth of your own bone preparing it to receive an implant.
Sinus Lift
The maxillary sinuses are hollow, air-filled spaces in the bone above our upper back teeth between the teeth and the eye sockets.
When the upper teeth (usually molars and premolars) are lost, the sinus cavity located just above tends to expand and drop down into the jaw bone in the area of the missing teeth. Sinus lift or elevation allows us to surgically lift up the floor of the sinus cavity and place bone graft materials that will stimulate adequate growth of bone for implants to be placed.
Sinus grafting can be done as a preliminary surgery to prepare the bone for implant placement or can be performed at the same time as the implant placement, if there is enough bone to stabilize the implants while they are healing.
There are two different approaches. One is called “lateral window sinus lift” in which we gain access to the sinus cavity through a window that we create in the bone below the space to be treated to receive implants. The sinus membrane is elevated, creating a small compartment where bone graft materials are placed along the sinus floor.
The other approach is called “Crestal sinus lift”. During this procedure we raise the floor of the sinus in the local area of the implant placement only. Usually this technique is performed for single implants and when there is enough remaining bone below the sinus floor.
Ridge Repair & Augmentation
When teeth are extracted, the bone typically shrinks both vertically and horizontally. The alveolar bone supports the teeth and when it no longer receives stimulation from forces on the teeth, it tends to melt away leaving an indentation in the gum tissue resulting in both cosmetic and potentially functional problems.
Areas with teeth that have been missing for a long time (due to periodontal disease, caries, trauma), and have been replaced with removable or fixed dentures, will often have so much bone resorption that there is not enough remaining to be able to place implants of adequate size.
Ridge Augmentation
Ridge augmentation is a specialized procedure that builds up lost bone and even gum tissue by using different surgical techniques. During this surgical procedure, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge and covered with a membrane to protect the bone and allow for better healing. This type of ridge modifications have been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.
Ridge augmentation may be performed as a preliminary surgery before the implant placement or, in some cases, it could be performed at the same time as implants are placed.
There are many types of bone graft materials available. We would choose the particular type that is most appropriate for you and your specific anatomic requirements. Healing of the ridge augmentation sites may take up to six months. After the healing period we will evaluate the results and plan for your dental implant placement!
Ridge Expansion
A related procedure to ridge augmentation is ridge expansion. This may also be performed at the time of implant placement surgery, or as a distinct first surgery to prepare the site to receive implants of appropriate diameter.
During this procedure, the jawbone in the treatment area is divided from front to back and in the inner and outer segments of bone are wedged apart. This creates a space between the divided sections that we will fill with new bone. This will enable us to increase the width of available bone to an appropriate size to accept implants – thereby replacing teeth.
Fortunately, Dr. Vergoullis utilizes an innovative and successful technique to perform ridge expansion with a piezotome device. Dr. Vergoullis has performed extensive research in this topic in which he lectures nationally and internationally.
