Soft Tissue and Bone Grafting
Soft Tissue Grafting
Soft tissues are sometimes deficient in areas of proposed implant sites and augmentation is required to optimize these sites for dental implants. This is accomplished by the use of a soft tissue graft. Soft tissue grafts improve tissue thickness and contours. They are most commonly used when implants are being placed to replace missing front teeth.Evidence in the literature stresses the importance of appropriate tissue thickness and quality for long term stability of tissues around implants. Soft tissue grafts may be harvested from patients’ own tissues, typically the palate. Alternatively, soft tissue graft substitutes may be used in certain cases. Appropriate gingival (gum) count ours are important to allow for ideal esthetic results. The stability of the gingival tissues and the potential results which may be achieved with soft tissue grafting depends on the status of your underlying bone. Dr. David will review the need for a soft tissue graft with you depending on your clinical presentation.
Major & Minor Bone Grafting
Over a period of time, the jawbone associated with missing teeth atrophies (shrinks)or is resorbed. This sometimes leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, bone grafting is considered. We have the ability to grow bone where needed in certain scenarios. 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 esthetics.
Bone grafting procedures may be performed separately or together with implant placement depending upon the patient’s bone status. There are several areas of the body that are suitable for attaining 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 attained from the hip or the outer aspect of the tibia at the knee. In some cases, bone substitute materials may be used.Allografts (bone is prepared from cadavers and used to promote the patient’s own bone to grow into the repair site) is an example of a bone substitute material.It is effective and safe. Xenogeneic bone is also used; bone from another species i.e cow bone which has been sterilized and irradiated for use.
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone. If your own bone is used it is taken from the jaw, hip or tibia (below the knee). In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.
Major bone grafts are typically performed to repair large defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are typically repaired using the patient’s own bone. This bone is harvested from a number of different sites depending on the size of the defect. The hip (iliac crest) is the common donor site. These procedures may be performed in an operating room or in an office setting in which a sterile room is used. Dr. David will review which option is best for you. This is day surgery, overnight stays are unusual.