Prior to the removal of a tooth, consideration should be given as to how the missing tooth site will be restored. Many times it is advisable to consider an extraction site preservation. When a tooth is extracted, the healing process begins. Unfortunately the gingiva or gum tissue grows at a faster rate than bone filling in the socket with tissue rather than bone. Many times this will leave the individual with a large defect in the jaw making it difficult to restore. This is especially true in the anterior regions of the mouth where the defect will appear unsightly. Extraction site preservation is extremely important when considering implants. Implants need the surrounding bone to stabilize and integrate.
Failure to consider extraction site preservation could limit the restorative options an individual has. Increasing the amount of bone is more difficult after the socket has healed and the surrounding bone has degenerated. The degeneration of bone from failure to perform extraction site preservation can compromise the adjacent teeth. In some cases the, the changes that occur with a healing socket can cause bone and tissue loss around adjacent teeth.
There are many different types of extraction site grafts and should should be aware of how and where these grafts come from. Talk with us about the best options for preserving your extraction site.
Above the maxillary posterior teeth lies the maxillary sinus. Often times the sinus will dip down between the roots of these teeth. If these teeth are lost and the extraction site is not preserved, there may be very little bone between the mouth and the sinus. In these cases a sinus augmentation is indicated in order to place implants. Proper radiographs with markers will allow us to determine if there is sufficient bone to place an implant or if an augmentation is necessary.
A sinus lift allows the sinus floor to be repositioned, creating enough space to properly place an implant. Various grafting materials are used to encourage your bone to grow more quickly into this area, helping to stabilize the dental implant. Over a period of several months, the graft material will be resorbed and your own bone will replace the graft material.
In certain circumstances, an even simpler procedure can be utilized. When possible, the bone remaining under the sinus floor is gently “pushed up”, thus lifting the floor of the “dropped” sinus. Bone replacement materials are then placed beneath this lifted bone. Once again the bone materials are replaced as your body grow new bone into this area.
Sinus augmentation procedures are highly predictable, with studies reporting over 95% success. Following sufficient healing of a sinus augmentation (6-10 months), implants are placed in a predictable and successful manner. It is important to realize that if the sinus augmentation procedure does not result in enough bone for implant placement, additional bone may be regenerated through a second sinus augmentation procedure at the time of implant placement.
Implant placement requires that there be sufficient bone, both in width and height to accommodate the implant. In cases where there is insufficient bone, a ridge augmentation may be indicated. The process involves lifting the gum from the ridge in the area that is deficient in bone. The patient’s own bone, harvested from another area, or cadaver bone like substance is used to fill the area needed to be augmented. A membrane may be placed as needed to keep the overlying gum tissue from growing into the space. With time, your bone will replace the graft material and an implant can be placed. The ridge augmentation can also greatly improve your appearance as it supports the overlying muscles. With ridge augmentation, the success of your implants will greatly improve and your implants will last for years.