Surgeries associated with dental implants are
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Bone graft
Bone graft should be done to replace resorbed bone after extraction. Bone graft can be done:
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Before implant placement: when there is no enough bone for implant placement, bone graft should be done, allowed to heal, then implant can be placed |
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With implant placement: when there is minor bone resorption, implant and bone graft can be done at the same time |
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After implant placement: when there is bone resorption after implant placement or for cosmetic reasons
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The bone graft can be from:
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The same patient:
- Intra-oral: from chin area or posterior area of mandible or maxilla.
- Extra-oral: form the hip, the leg, the rib…. |
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From another person: all cells are removed, usually from cadavers. Studies have shown the safety of this graft and there is no report for disease transmission when this graft used for bone graft intra-orally. |
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From animals: (like cows and horses) all cells removed, studies have shown the safety of this graft and there is no report for disease transmission when this graft used for bone graft intra-orally.
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Synthetic |
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Sinus bone augmentation (Sinus lift)
Sinus bone augmentation (lift) is done to replace the resorbed bone due to enlargement of the sinus (pneumatization) after teeth extraction. It can be done:
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Before implant placement: when there is no enough bone for initial implant stability, sinus bone augmentation is done firs, then implants after 6-8 months |
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With implant placement: when there is enough bone for initial implant stability, sinus bone augmentation is done with implant placement simultaneously |
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There are two ways for sinus bone augmentation:
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Internal: through the implant hole. This is the easier way but it can be used to lift the sinus floor from 1-4 mm, if we need to lift it more, we should use the second way. |
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External: by making a window above the upper molars and premolars for sinus floor elevation and bone graft. This way is used when we need to elevate the sinus floor 5 mm or more |
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Sinus bone augmentation is a safe procedure and it will not cause any severe or chronic problems in the sinus. In very rare occasions, infection of the bone graft in the sinus may happen, especially when the external way of lifting used. In this cases antibiotics should be given, but if infection continues, the area should be re-opened, cleaned, all bone graft should be removed, and new bone graft is placed or wait until the area healed (depend on surgeon preference). This should take care of the infection in most of the times.
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Soft tissue graft
Soft tissue graft can be done:
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Before implant placement: to prepare the soft tissue to receive the implant, in case there is soft tissue deficiency and need for bone graft |
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With implant placement: when there is no enough tissue to cover the implant or to thicken the tissue around the implant |
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After implant placement: if the implant can be seen through the soft tissue, or when there is recession around the implant |
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Soft tissue graft is done in the same way used for treatment of gingival recession.
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