Penam Periodontics - Evidence based Personalized Periodontics

Bone Grafts for Implants.

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in 8-12 weeks. However, when the walls of the extraction socket are: 1) very thin; or 2) when you have significant bone loss due to: A) infection; or B) fracture of the tooth socket bone during the extraction of the tooth. In these situations a bone graft can be placed: 1) at the time of the tooth extraction; 2) at the time of the placement of the implant; or 3) between the extraction and placement of the implant. The graft will increase the width and volume of bone supporting the implant. The decision as to which is most appropriate will be determined at the time of planning the case.

Bone grafting can occur using many different bone-grafting materials, including the patients own bone.

Bone grafting into the maxillary sinus to increase the level of bone to support the implant can be done if insufficient bone exists. Early implantologists claimed that penetration of the implant into the sinus would result in the development of chronic sinusitis. However research has shown that does not occur. In fact bone will frequently develop around the implant which perforates the sinus leading to an increase in the amount of bone. Research also shows that there are more complications following sinus grafting than having an implant penetrate the sinus. The research potentially indicates that an amount of bone in the sinus floor of a minimum of 5-6mm most likely does not need to be grafted.

A “sinus grafting procedure” may be a treatment alternative where the bone depth in the sinus floor bone is <5-6mm. This procedure can be performed prior to implant placement or at the time of implant placement. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed.

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