NJ Periodontology Specialty Permit #3925

100 Town Center Drive

Warren, New Jersey

Tel: (908) 222-3337

Fax: (908) 222-0032

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Bone Regeneration/Grafting/Ridge Augmentation and Sinus Elevation

Sinus Elevation

Sinus elevation (also known as sinus lift or sinus graft) is a procedure in which bone is added to the upper jaw, or maxilla, in the area of the premolar and molar teeth. When a tooth is lost or as we age our sinuses grow larger in volume, and take away jaw bone from the ridge this is not a pathological condition, on the contrary it is a normal condition it happens to every one. This process is called Pneumatization of the Para-Nasal Sinuses. Therefore it is challenging to replace missing teeth with dental implants in the posterior part of the mouth in some cases where the sinuses are very low. However with the sinus elevation procedure the goal is to raise the bottom of the sinus up graft bone underneath and thus create enough space for one or more dental implants.

The sinus elevation procedure is done under local anesthetic, but if the patient is apprehensive the procedure can be done using IV-Sedation. The procedure is done using a sterile protocol the same as if the patient were to have the procedure done in an operating room in the office. Dr Chin chose to use this sterile protocol for sinus elevations to prevent any post operatory complications. After the patient is comfortable the procedure initiate by doing what we call a mucoperiostal flap which means that an incision is made to expose the maxillary wall of the sinus. Then a window is made on the maxillary sinus wall to allow elevation and grafting of that area.

Frequently people are curious to know how long it takes until the implants can be placed in the site that was grafted. There are cases in which the sinus elevation and the implant placement can be done at the same time which expedites treatment. However there are some cases that we have to wait for the bone to mature.

Another frequently asked question is where the bone that is being used in the grafting come from does. There are several types of bone grafting material, but the grafting that is used this procedure is called an allograft. An allograft is defined as tissue graft between individuals of the same species (humans), but with non identical genetic composition. Allografts are generally harvested from cadavers. However the risk of cross infection is eliminated by processing. The reason why we do not use an autogenuos, which is your own bone, is because a lot of bone graft is necessary for a sinus elevation surgery therefore we would need to remove bone from a large site, and also there would be a second surgical site in this case.

Ridge Augmentation

Ridge Augmentation is also referred to as socket grafting or grafting of a buccal wall defect, this procedure is a common dental surgery that may be performed following the extraction of a tooth to help recreate the contour of the gums and jaw that may have been lost due to bone loss following or as part of a tooth extraction.

The alveolar bone is the bone that surrounds the root of the teeth. When a tooth is removed it leaves behind an empty socket in the alveolar ridge bone. Typically this empty socket will heal on its own filling in with bone and tissue. Sometimes the wall of the socket is thin and breaks during tooth removal or was missing before the procedure. When the bony wall holding the tooth into the jaw on the side facing the cheek is missing it is called a buccal wall defect. These types of sockets usually do not heal to their previous height and width because they do nothave intact bony walls to guide the bone regeneration. Therefore in that case bone will continue to be lost because there is no tooth to retain the bone.

Rebuilding the height and width of the alveolar ridge is not critical to the patients overall health, unless the patient wants to replace the original tooth with a dental implant or the lost tissue has caused an aesthetic problem. Dental implants require a certain amount of bone to the base of the implant. Grafting the site guides the bone to healing preventing bone resorption after tooth extraction and preserve height and width of the alveolar ridge.

A ridge augmentation is done using local anesthetic. The ridge augmentation consists of putting graft material into the socket. This may be done immediately after the tooth has been removed, eliminating the need for a second procedure later. After the site has been grafted a membrane is placed over the wound before it is sutured. The membrane is used to protect the site from food particles and saliva from getting in, and also the membrane prevents soft tissue from growing into the defect and it also helps to preserve the height and the width of the site it acts as a space maintainer. However results are specific to each individual.

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Copyright © 2012 Anthony T. Chin, D.D.S. All rights reserved.