Over a period of time, the jawbone associated with missing teeth atrophies or is resorbed. This often leaves a condition in which there are poor quality and quantity of bone for cosmetic tooth replacement.
In patients opting for treatments involving dental implants, sufficient bone height and width is necessary for stabilization and complete bone encompassment of the implant.
Patients whose treatment includes the use of "Crowns" and "Bridges" also need sufficient bone and gum tissue present so that the new dental work appears natural. Proper ratios of the amount of gum and tooth showing are critical for ideal smile design. Many times in this situation, the appearance of the full bone and gum tissue is all that is needed to make the cosmetic dentistry appear natural.
Today, in many situations, we have the ability to grow bone and tissue where needed. This not only gives us the opportunity to place implants of proper length and width or "Bridges" with proper tissue ratios, but it also gives us a chance to restore functionality and esthetic appearance.
We have a number of ways to redevelop bone and tissue height and width to meet cosmetic and functional demands. Although it is impossible to guaranteethe exact amount of bone or tissue an individual's body will develop, these procedures predictably achieve the desired effects.
The development of increased bone width can be achieved via Guided Bone Regeneration and Ridge Expansion (Splitting).
Guided Bone Regeneration is achieved by adding additional layers of bone material on the existing bone with the intention of guiding the body to develop its own bone in those locations. Once anesthesia is achieved, bone graft material is added to the designated sites of treatment. Typically, a membrane ("Barrier") is placed over the graft material to aid in its stabilization.
The graft material used is typically in the form of a powder or solid block. There are synthetic and donor tissues available. In some circumstances, patients may opt to utilize their own donor bone from other sites in their mouth. Dr. Cohen can review with you the options most suitable for you. In some cases, dental implants can be placed at the time of augmentation. Often, a 6-9 month period of bone development is first needed prior to implant placement.
Ridge Expansion (Splitting) is another method of widening bone without the need for graft material. In some cases (varies per patient), certain areas of bone can actually be expanded due to its spongy or elastic capabilities. In many cases, dental implants can be placed at the time of ridge expansion. Both of these types of procedures may take more than an hour to complete. Patients may experience some swelling and bruising due to the nature of the procedures.
The development of the appearance of full bone and tissue can also be achieved with Soft Tissue Ridge Augmentation. The goal is to thicken the areas requiring treatment, so they appear fuller. Soft Tissue Augmentation typically utilizes either transplanted thick tissue from the palate or donor tissue. This tissue is then placed between the existing gum and bone to "plump" up the area. This procedure is similar to the one described in the Gingival Grafts section.
It is important to understand that these procedures were developed to help you regain tissues your body has already lost. In essence, we are creating human tissue. With that I mind, there is no way to guarantee your body will regenerate new tissue. It is also important to realize that certain medical considerations such as smoking and diabetes (along with a host of others) play a major role in success as well. Some patients are poor candidates for these treatment options. Dr. Cohen will review all conditions pertinent to you when discussing any of these procedures.