What is bone grafting?

Bone grafting is a commonly used method to supplement the implantation conditions of dental implants by implanting artificial bone powder. The advantage of artificial bone powder is that there is no need to damage the autogenous bone, and the rate of bone resorption is very slow. Generally, the amount of implantation is very small, and it is calculated in grams. Before implantation, the density and height of the alveolar bone will be strictly measured to achieve accuracy. Bone grafting is not that terrible. It is to put artificial bone meal directly into the alveolar bone, so that it and the alveolar bone are gradually combined together for implant placement. During this combination, the gums will not feel discomfort or pain.

Bone meal is suitable for the expansion or reconstruction of alveolar bone, the filling of the defect of the mandibular alveolar bone, the filling in the extraction socket to protect the alveolar bone, the filling of the missing bone tissue around the implant, and the maxillary sinus lift. Do people need bone grafts before dental implants? Because the "height", "width" and "density" of the bone will directly affect the success or failure of the implant, and whether the implant will be durable in the future. Let's make a simple analogy, and everyone will understand: planting trees requires soil for saplings to grow healthily. The same principle applies to dental implants. Since it is a "planting", it needs healthy bone tissue to complete it successfully. Therefore, before the patient is implanted, the doctor must do a detailed examination and evaluation, and then decide whether to perform bone reconstruction (commonly known as psoralen) or sinus augmentation before implantation.

Generally speaking, the height of the alveolar bone needs to be at least about 1 to 1.2 cm, and the width is about 0.6 to 0.7 cm or more, and the bone density must reach a certain standard to achieve a safe dental implant range. Just like nailing a nail to a wall, the thicker the wall (higher bone height) and the stronger the material (higher bone density), the higher the success rate of implantation, the more stable the implant, and the greater the bearing capacity after implantation. Bite force.

In addition, bone graft surgery depends on the degree of bone defect in the patient, and the timing of the operation is different. Sometimes it can be performed at the same time as the tooth implant, and sometimes it must be completed one after the other. So why do these people have poor alveolar bone conditions? Generally, it is because of missing teeth for many years without any treatment, or severe periodontal disease. These conditions can easily lead to alveolar bone atrophy, which is not enough to support the growth of dental implants. There are also a very small number of patients whose bone quality is so poor that they cannot be repaired at all, and of course they cannot be artificially implanted. At this time, it is recommended to use traditional dental bridges or movable dentures for treatment. Conditions that need to be met for bone grafting:

1. Good biocompatibility is a requirement for dental implants and bone grafting.

2. The ability to restore the normal shape and function of the bone in the defect area is also a requirement to be met by dental implants and bone grafts.

3. Osteoinduction or bone guidance is also a requirement for dental implants and bone grafting.

4. The absorption rate of the bone graft material is coordinated with the rate of new bone formation, otherwise the bone graft material absorbs too fast, which will lead to osteogenesis failure.

5. Revascularization can happen quickly, which is also a requirement for dental implants and bone grafts to promote bone healing.

6. The requirements that need to be met for dental implant bone grafting include not affecting the osseointegration between the new bone and the dental implant. Steps of dental implant and bone grafting:

1. The incision is a transverse incision from the maxillary canine to the gingival buccal sulcus of the first molar. The mucosa and periosteum are cut open, and the mucoperiosteal flap is separated to expose the bone surface of the outer wall of the maxillary sinus. Do not damage the infraorbital nerve.

2. Use a 2mm diameter ball to drill a rectangular window on the bone surface according to the size of the sinus cavity. When drilling, only penetrate the bone wall and do not damage the mucous membrane.

3. Separate and move the bone mucosal flap from the bottom of the maxillary sinus. Use a nasal mucosal peeler with a suitable curvature to carefully separate the bone wall and push up the sinus mucosa to the height of the bone graft. Generally, move it up to 1.5cm. The sinus membrane is very thin, only about 0.1mm on average, just like a balloon is easy to rupture. Once ruptured, it will directly affect the effect of the operation. The main cause of maxillary sinus mucosal perforation is the mucosal condition and surgical operation.　　

4. Implant artificial bone meal to cover the oral repair membrane, if the periosteum is intact or not cover the membrane.　

5. If planting at the same time, separate and flip the mucoperiosteal flap along the gingival-buccal sulcus incision to the palatal side to expose the alveolar ridge bone surface, drill holes step by step at the designed position, and finally screw the implant into place. If the bone height is severely insufficient before surgery, it can also be implanted half a year later. After the root is implanted, it is best to have a recovery period of 1.5 to 3 months. It is determined that the gums are growing well before a permanent replacement tooth can be installed. Some patients are in good health and recover quickly, and some patients have a particularly slow recovery period and need more time to wait for the bones to heal. Compared with direct implantation, this kind of dental implant surgery that requires bone grafting is more troublesome. Therefore, for the sake of oral health, and to save time and money, it is recommended that patients with missing teeth should be repaired as soon as possible to avoid deterioration of the foundation. At the same time, bone graft surgery must be performed in a professional and regular dental institution to avoid unnecessary risks.