[More About Dental Implants] Why Do Dental Implants Require Bone Restoration? A Quick Guide to Bone Restoration Surgery (Part 1)
Before undergoing dental implant surgery, many patients are advised by dentists to have "bone grafting" done first. What exactly is "bone grafting," and does everyone need to have "bone grafting" done before "dental implantation"?
What is bone strengthening?
Bone grafting is a surgical procedure used to fill in the gaps left by missing teeth. It involves filling the atrophied alveolar bone with bone graft material, increasing bone strength, and ensuring the alveolar bone is wide, high, and stable enough to support the implant. Bone graft material acts as a medium to help bone grow; only after osseointegration is complete and the alveolar bone has returned to a stable state can subsequent dental implant surgery be performed.
Why is bone grafting surgery necessary for dental implants?
Some patients who have been missing teeth for more than a year without treatment may experience alveolar bone loss and atrophy. Before dental implantation, a stable foundation needs to be laid. Bone grafting acts like this foundation; only by stabilizing the gum base can a durable and long-lasting tooth be rebuilt. Therefore, if a patient has severe alveolar bone loss, dentists usually recommend bone grafting surgery to ensure the correct proportions of the implant crown, allowing the implant to be more secure.
What is the process of making bone-strengthening powder?
First, the dentist will administer anesthesia to the patient, then make an incision at the surgical site using a microscope. After that, a minimally invasive flap will be opened and the wound will be cleaned. After filling with bone grafting powder, a regenerative membrane will be placed on top, and finally, the suturing procedure will be performed.
What are the different types of bone grafting surgery?
(1) Spinal preservation surgery:
After tooth extraction, alveolar bone may be absorbed, leading to changes in shape or insufficient space in the future. "Bone ridge preservation" involves placing regenerative materials, such as collagen, bone powder, regenerative membranes, or PRF, into the tooth socket to preserve the area of bone in the extraction site. This method allows tooth extraction and bone grafting to be completed in a single surgery, requiring only one wound healing period for the patient.
(2) Horizontal osteotomy:
In some patients, the alveolar bone loss results in insufficient width. "Horizontal bone grafting" can increase the horizontal volume of the alveolar bone, allowing for sufficient thickness filling and creating an environment suitable for implant placement. The difficulty of horizontal bone grafting surgery varies depending on the extent of alveolar bone loss. If the loss is large, autologous bone may be required as the filling material.
(3) Sinus augmentation:
"Sinus augmentation" is also known as maxillary sinus augmentation. The maxillary posterior teeth region is an air-rich bony cavity. When there are gaps in the upper posterior teeth, alveolar bone loss and maxillary sinus expansion are common, resulting in insufficient bone height and width, making it difficult for dental implants to have a stable foundation. Through "sinus augmentation," the maxillary sinus membrane is lifted upwards, and then bone graft material is used to fill the bottom of the sinuses in the maxillary posterior teeth region, restoring the alveolar bone to its proper height and ensuring sufficient space for implant placement.
(4) Vertical bone augmentation
If dental implants are performed when the alveolar bone is insufficient in height, the implant may be exposed due to the lack of sufficient height. Therefore, a "vertical bone augmentation" procedure is necessary. Dentists use a large amount of bone graft material, and may even utilize supporting bone screws, special regenerative membranes, and other consumables to reconstruct sufficiently stable alveolar bone, bringing the bone to the appropriate height. "Vertical bone augmentation" is one of the more difficult of the four surgical methods. Dentists must consider both the height and width of the alveolar bone, as well as the tissue structure. This procedure also requires a longer recovery period.
Author: Dr. Chen Haoxian
