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Bone Regeneration

When teeth are extracted, the jawbone associated with the missing teeth atrophies, or resorbs. Often, this results in a situation where there is not enough remaining bone to allow for implant placement without regenerating, or “re-growing,” the lost bone. Today, we have the ability to regenerate bone where needed so the question is no longer, “can an implant be placed?” but rather, “what needs to be done to prepare the site prior to implant placement?”

Horizontal Bone Augmentation

When you lose your teeth, the nature resorption process can result in significant bone deterioration, making the site where a tooth or teeth were lost too narrow to fit a dental implant. To regenerate your lost bone dimension, one technique includes securing blocks of bone with titanium screws. Once healed, the bone graft will facilitate dental implant placement, allowing your dentist to replace your previously missing teeth. Case Study 1 A 65 year old female presented to a local prosthodontist noting she was unhappy with her smile and stated, “I know I need a lot of work done and now I am emotionally and financially ready.”        Photographs and images from CBCT show severe combination vertical and horizontal ridge atrophy (loss of dimension). Significant bone loss requires horizontal and vertical bone augmentation to allow for placement of dental implants in the correct position (note red areas on CBCT image illustrating area where horizontal bone was lost requiring augmentation). proceedures2 Plan for implants to be placed in the correct position after bone augmentation proceedures3 Ridge augmented using bone graft and titanium mesh membrane with tacks proceedures4 Only five months after bone grafting,the patient’s gingiva (“gums”)  are healthy and the bone grafts are ready for implant placement proceedures5 Rebuilt ridge dimension allows implants to be placed in the correct position proceedures6                         Before bone graft                                               5 months post bone graft Cross-sectional slices of CBCT showing gain in bone width of approximately 5 mm at all four augmented sites. Note the difference in the ridge dimension pre-grafting (red lines) versus 5 months post grafing (green lines).

    Upper right second premolar site (15 site)                Upper right first premolar site (14 site)

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    BEFORE & AFTER                                      BEFORE & AFTER

       Upper left first premolar (24 site)                         Upper left second premolar (25 site)

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    BEFORE & AFTER                                      BEFORE & AFTER

Implants successfully placed in grafted bone in the correct position

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Photographs before treatment and after bone augmentation and dental implant placement