Block Bone Regeneration
The amount of bone needed to support dental implants and keep them stable long-term is based on the amount of the available bone, its location and/or residual soft tissue defect.
Bone regeneration provides implant sites that have adequate bone structure to support implants where gum disease, previous extractions, infection or injuries have occurred. The bone is obtained from a tissue bank, synthetic, animal bone or your own bone is transferred from the jaw or another location.
For Medium to Larger Sized Defects:
When regenerating bone at medium to larger bone defects, the failing tooth or teeth must be extracted and the missing bone replaced. The implant is then placed later at a separate visit. When treating a moderate sized defect using Guided Bone Regeneration or GBR, a reabsorbable or non-reabsorbable membrane is used to help protect and regenerate the missing bone. When bone is transferred from one area of the body (usually from the lower jaw) to another, this is called Block Bone Regeneration (Block Bone Grafting).
Block Bone Regeneration
The amount of bone or tissue needed to support dental implants and keep them stable long-term is based on the desired outcome for your mouth, your concerns and most importantly the condition of your mouth, specifically the remaining amount of bone and soft tissue. Bone regeneration procedure recommended is hence based on the type of teeth chosen, which effects the amount and location of bone needed. We START with your desired results in our planning as this often greatly affects the treatment recommended.
When teeth have an infection, decay, and trauma, or are extracted, this can leave a moderate to severe bone defect and it is here that block bone regeneration is used. Most often significant bone loss is the result of wearing a denture or partial denture for a number of years, since the bone slowly melts away each year from lack of direct stimulation and the continued irritation of the denture or partial denture. Any of these situations can leave too little bone for implant placement and building up the bone before the implants are placed is considered.
When a diseased tooth is removed, often much bone around it has been lost from the infection/trauma.
When the jawbone is too thin or not tall enough, a bone grafting or regeneration procedure may be needed, many methods are available.
1. Bone is transferred from one part of the mouth to another, usually donated from the chin or wisdom tooth area of the mouth.
2. Bone can also be transferred from another part of the body, from the tibia or hip.
Bone Grafts transferred from below the front teeth or from the wisdom tooth area are commonly used, with the wisdom tooth area being used far more often than any other donor site in the body. The hip bone is used in the most extreme cases and rarely is it used since the transferred bone is lost in unpredictable amounts and can be lost years later. It is also a costly procedure that insurance seldom covers and it is traumatic. This bone loss after it is transferred happens also with bone transferred from the mouth, although potentially less problematic. Hip grafts are procedures typically requiring hospitalization and are most often used when no other options are available. Today, I more frequently use growth factors to stimulate a more natural bone replacement rather than using hip grafts. Tibia bone grafts are used to get live cell yet don't provide any solid pieces of bone to develop the desired bone contours and shape. Hence their use is limited.
This transferred bone is attached to the deficient site and it becomes attached to the site in 4–6 months. This can be accomplished with or without growth factors to stimulate the body's natural reparative mechanisms. This creates a solid base for the dental implant and supports chewing forces that can be up to 1000 pounds per square inch!
The resulting ridge is then wide enough to accept a dental implant. The donor site heals completely, regenerating the lost bone in less than 1 year's time.
Other methods I routinely use instead of bone grafts as described above are Ridge Expansion, using Growth Factors, Sinus Bone Regeneration and Guided Bone Regeneration.
Advantages of Bone Grafts (transferred bone)
Disadvantages of Bone Grafts
Cases #1 & 2 and "Single Teeth" cases show block bone regeneration, bone transplanted from the mouth treatments for patients under CASE STUDIES.
Case #4 shows a patient that had hip bone regeneration under CASE STUDIES.