Bone regeneration and grafts
There are cases in which, for various reasons, the necessary bone is not available to be able to rehabilitate a mouth with prosthesis on implants.
In these cases it is important to carry out a study and an assessment to determine if it is possible to regenerate that lost bone, thus allowing a correct rehabilitation with dental implants.
For the placement of dental implants a minimum volume of bone is required for their anchorage, hence the importance of having a good quantity and quality of bone.
Grafts help us to recover lost tissues due to different causes, either due to dental extractions, cysts or the need to increase the amount of bone in order to carry out a satisfactory rehabilitative treatment.
There are multiple types of grafts, materials and techniques:
Types of Grafts
- Autologous: obtained from the individual himself. Bone can be extracted from different areas of the jaw or from other parts of the body such as the hip or the fibula. The area to obtain the graft will be determined by the amount of bone required and the quality of the bone.
- Of animal origin (xenografts): These materials come mainly of bovine or porcine origin. These materials are strictly prepared, sterilized and passed through the strictest controls in order to be used in humans. All of them are approved by the competent agencies for their use.
- Of human origin (allografts): They are those from another genetically different individual. Like xenografts, they are strictly processed to remove any incompatible antigen present.
- Artificial (alloplastic): These materials include Hydroxyapatite, Calcium Sulfate, ceramics, etc.
Plasma Rich In Growth Factors (PRGF)
Plasma Rich in Growth Factors (PRGF) is one more factor that helps us to regenerate tissues and prevent bone resorption after, for example, an extraction or after the removal of cysts.
PRGF is obtained from the patient's own blood. With a small amount, a platelet concentrate rich in growth factors can be obtained in a very simple way, which are nothing more than proteins found in the plasma of each individual and inside the platelets, capable of stimulating the growth of hard and soft tissues.
As a result we can prepare areas where dental implants will be fitted at a later date.
Using this technique, we can also regenerate bone that has already been lost, for example in narrow jaws. When dental implants expose threads because of their thickness, we can cover them with PRGF together with other materials to create a thicker bone mass. We can also add height by filling in the paranasal sinuses with this material, mixed with bone substitutes (sinus lift), making it possible to fit dental implants in the rear of the upper jaw, an area that is often difficult to work with due to the low height of the bone, which is nearly always of poor quality
The professional will be in charge of selecting the type of graft necessary for each case.
Sinus lift or sinus augmentation is an oral surgery procedure in which a bone graft is placed in the maxillary sinus to allow implant placement.
The maxillary sinuses are air-filled cavities found inside the face. Over time, they can begin to expand due to various causes. One is the lack of teeth that delimits it.
If the sinus is so extended that there is not enough bone height available, it will not be possible to place implants there without first grafting. This type of graft technique is known as a sinus lift.
It consists of accessing the sinus, lifting the sinus membrane and filling it with bone graft material, which can be artificial, from animals or from the same person.
Finally, a membrane is placed in the access area, which will gradually be reabsorbed. After the intervention, the graft is allowed to heal for 6-9 months before placing the implants. In certain cases, it is possible to place the implants simultaneously in the same surgery.
Socket preservation after tooth extraction
After tooth extraction, the bone surrounding the root of the tooth begins to reshape itself and partially fill the gap left by the root.
There are techniques to promote this bone regeneration, which are performed at the time of extraction.
This technique helps prevent bone atrophy due to tooth extraction. It consists of filling the socket with a bone graft or plasma rich in growth factors and later covering it with a membrane in the necessary cases of bone grafting. The bone healing process will take several months depending on the material used and the membrane will gradually resorb. Once the bone has healed, implants can be placed.