Bone Regeneration Bone Regeneration

Sometimes, trauma or disease damages a tooth to the point that it can’t be saved. Fortunately, patients today have many choices for replacing their natural teeth, including implants, removable dentures, and fixed bridges. These solutions often look just as good as natural teeth, and can restore your natural appearance, while letting you lead an active lifestyle. Without healthy bone in the jaw, however, there is no foundation to support any of these replacement options. Today, more than ever, advances in medicine and dentistry have led to new and expanded areas of treatment. Three such areas; sinus lift, bone grafting and guided bone regeneration (GBR) in the jaw bones and around teeth, have recently experienced tremendous growth. Procedures to repair and grow new bone, unheard of just a few years ago, are now part of routine dental surgical care. The following information will help you better understand what is a sinus lift, bone grafting and GBR, as well as what options are available to you and what benefits you may gain from these procedures.

What is a Sinus Lift?

The maxillary sinuses are located in the cheek bones below your eyes. Tooth loss below the sinus leads to bone loss and over time the sinus will expand into the area previously occupied by bone and teeth. If a dental implant is placed into inadequate bone it will move, shift and fail because there isn’t enough stability to withstand forces of biting and chewing. A common way to resolve this is by performing a sinus graft or lift. A sinus lift begins with a temporary opening made in one of two possible areas. An instrument then modifies the sinus membrane to its previous position providing clearance for the placement of substitute bone. Adequate bone regenerating tissue is placed to provide enough support for the placement of a dental implant. Over time the substitute implant and bone will heal creating a strong bond and a stable foundation for your new replacement teeth.

What are bone grafting & guided bone regeneration?

Bone grafting is a surgical procedure that replaces missing bone with special material called Bio-Oss®. This material not only replaces missing bone, but also helps your body regrow lost bone. This new bone growth strengthens the grafted area by forming a bridge between your existing bone and the graft. Over time the newly formed bone will replace much of the grafted material. Guided bone regeneration is a procedure in which a thin membrane called Bio-Gide® is placed over the bone graft site. This membrane further encourages new bone to grow and also prevents the growth of scar tissue in the grafted site. More information about Bio-Oss® and Bio-Gide below.

What are the indications for a bone graft or guided bone regeneration?

Bone grafts and guided bone regeneration are needed when you have too little bone tissue in the oral cavity. This missing portion of bone is frequently called a “bony defect”. The indications include:

  • defects surrounding roots of teeth (periodontal defects)
  • defects which occur following tooth extraction
  • decrease in quantity of jaw bone from trauma
  • decrease in bone quantity due to long-term tooth loss
  • insufficient bone quantity prior to implant procedure
  • defects resulting from a cyst or tumor surgery

How can I find out if I have a sufficient amount of bone for an implant?

By conducting a series of diagnostic images including an orthopantomogram and a computed tomography, our implantologist will be able to determine the quality, density and quantity of your bone tissue. Furthermore, diagnostic imaging allows us to assess the surrounding anatomical structures to avoid during the implant procedure such as nerves or sinuses.

How are bone grafting and guided bone regeneration procedures performed?

  • The tooth is removed and the remaining tooth socket is thoroughly cleaned of all inflamed and infected tissue.

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  • Bone grafting material (eg. Bio-Oss®) is carefully placed into the extraction socket.

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  • A guided bone regeneration membrane Bio-Gide® is placed over the grafted material.

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  • Sutures placed into the gum tissue allow proper healing of the surrounding soft tissues.

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Are bone grafting & guided bone regeneration painful procedures?

These procedures are done in the clinic under local anesthesia. The procedures themselves are without pain. Post-operatively, there will be some swelling and some mild to moderate discomfort. If you experience pain in the first two days after the procedure, standard over the counter oral analgesics may be taken to help relieve your discomfort.More information about post surgical care..

What special care is required after my grafting procedure?

Generally, the same prudent care required after any dental surgical procedure will be sufficient. The area must be kept clean, often with the help of a prescribed mouth rinse. An antibiotic, if prescribed by our dentist must be taken. Antibiotics, however, are not always required. Undue pressure over the grafted site must be avoided until new bone is well on its way to being formed. Brush and floss your teeth as you normally do. However, avoid the gum tissues surrounding the bone graft until they are well healed (usually about six weeks).

What is Bio-Oss®

Bio-Oss® is a safe, effective bone graft material from specially processed bovine sources. Under the electron microscope, Bio-Oss® looks very similar to human bone. Because of its similarity to human bone, Bio-Oss® is highly successful in helping new bone to form. In many cases using Bio-Oss® eliminates the need for additional surgery to obtain your own bone as grafting material.

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How does Bio-Oss® work?

Since Bio-Oss® is so similar to human bone; it is readily accepted by our defense mechanisms as a “friendly” graft and is therefore not rejected. Bio-Oss® acts as a framework onto which bone forming cells, blood vessels, etc. migrate. As these cells and blood vessels travel along the Bio-Oss® framework, healthy new bone is formed and the defect is repaired.

Is Bio-Oss® safe?

Bio-Oss® is completely safe. Since it is highly purified bone, no allergic reactions or infections have been observed following its use. Every batch of Bio-Oss® goes through highly controlled processing and sterilization procedures which remove all impurities. At the end of these procedures, every batch of Bio-Oss® must pass rigorous tests for purity and sterility, assuring the total safety of the materials.

How long does it take for new bone to form around the Bio-Oss® graft?

Bio-Oss®, because of its similarity to human bone, is highly successful in supporting new bone growth. Although new bone will begin to form within the first few weeks after grafting, several months are required to achieve the quantity and density of bone needed for further dental or surgical procedures to be performed .

What is Bio-Gide®?

Bio-Gide® is a thin resorbable membrane made from the natural fiber material, collagen. Often when a bone graft is needed, Bio-Gide® is placed directly over the grafted material. Bio Gide® encourages new bone to form and also prevents the growth of scar tissue into the grafted site. Bio-Gide® is resorbable (melts away) and therefore, unlike membranes which do not resorb, does not need a second surgical procedure to be removed. Unlike most other resorbable membranes which tend to resorb in 4-8 weeks, Bio-Gide® lasts at least 4 months, the time required for new bone to form. And lastly, during healing, if an opening occurs in the gum tissue covering Bio-Gide®, the opening will tend to close spontaneously, allowing bone growth to continue. Removal of the Bio-Gide® membrane is almost never required.

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Is Bio-Gide® safe?

Bio-Gide®, like many artificial heart valves, is composed of porcine derived collagen. Using special processing and sterilization procedures, Bio-Gide® is made completely biocompatible and sterile. Every batch of Bio-Gide® membranes undergoes a series of tests confirming its purity and sterility, assuring total safety of the materials. Bio-Gide® is not indicated for patients with a known history of allergic response to collagen or porcine derived products.

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