Bone Grafting for Dental Implants

Do I have enough bone for dental implants?

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for dental implant placement several months later.

An example of a jaw with inadequate front bone structure to support an implant
1. Inadequate Bone
A depiction of the placed bone grafting material to increase the bone structure
2. Graft Material Placed
A representation of dental implants placed after bone grafting
3. Implants Placed

There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including your own bone.

A jaw lacking enough bone in the back of the mouth for a dental implant
1. Inadequate Bone
An example of a dental implant after adding jaw structure with bone grafting
2. Graft Material and Implant Placed

You may also need bone grafting if the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.

Bone grafting Using a Minimally Invasive “Ridge Split” Procedure

Have you been told you were not a good candidate for dental implants? Or you need “an invasive and expensive” bone grafting procedure?

At Orange County Oral Surgery and Periodontics, we offer a time tested, minimally-invasive procedure for many patients in need of Dental Implants without the expense and the down time more traditional bone grafting procedures offer. Traditionally surgeons addressed thin jaw bones by harvesting bone from other parts of the body and placing it on the deficient areas of the jaws to prepare the site for dental implants. Today we can offer a less invasive procedure to accomplish the goals we achieved using other, more invasive bone grafting techniques.

Ridge Split technique was developed in 1990s but did not become a mainstream procedure in many oral surgeons offices. Lack of experience, proper instrumentations and inadequate understanding of jaw bone behavior were the main reasons why this procedure did not gain popularity early on.

Who is a good candidate for Ridge Split Procedure?

If you had removed a tooth a while ago and you are now looking to place an implant in the missing area, you may not have enough bone for dental implant placement. In other words, your jaw bone may be thin to place dental implants. If your jaw bone is compromised or thinned out due to loss of a tooth, you may be a candidate for a Ridge Split Procedure.

How is the procedure performed?

  

Ridge Split Procedure may be performed under twilight anesthesia or if you choose, we can perform this procedure by using local anesthesia which is simply numbing the area for the procedure.

A small opening is created where placement of dental implants are treatment planned. The jaw is precisely outlined in the center and with specialized instrumentations; the bone is gently widened or “split” to a desired width. The dental implant may then be placed in the exact desired position.

Does this procedure have any down time? Oral surgery procedures can have some down time. Compared to other more invasive bone grafting procedures, ridge split procedure may have the least down time.

Are Implants placed at the same time as the Ridge Split Procedure? Implants maybe placed if your jaw bone is soft and expandable. Typically, the upper jaw is more easily expanded and simultaneous implant placement may be possible. The lower jaw is more rigid and implant placement may be done simultaneously or at a later time.

What are the possible complications of Ridge Split Procedure? Ridge split procedure as compared to other more invasive bone grafting procedures has fewer complications in an experienced surgeon’s hands. Uncontrolled and unwanted fracture of the split segments is the most common complications. In these rare instances, the bone splitting is completed along with bone grafting and implants are placed at a later date, usually within 3-4 months.

Who performs this Procedure? You should seek an experienced Oral and Maxillofacial Surgeon to perform this tedious, yet minimally invasive surgical procedure. Dr. Reza Bolourian, a board certified Oral and Maxillofacial Surgeon has over 15 years of experience in various surgical procedures in the head and neck region and has performed over 200 ridge split procedures for patients seeking dental implants.