William A. Buche, DDS

Oral Surgery

San Angelo, TX

(325) 949-1288

Procedures

• Dental Implants
• Wisdom Teeth
• Bone Grafting
• Oral Pathology
• Facial Trauma
• Intravenous Sedation
• TMJ
• Orthognathic Surgery
• Sleep Apnea

Bone Grafting

Major & Minor Bone Grafting

Over a period of time, areas of the jawbone associated with missing teeth atrophy or are resorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. Sometimes bone can be lost in traumatic events, along with teeth. With bone grafting procedures we can often restore  that person to the level of function he or she deserves.  

We have the ability to graft prepared and purchased matrix materials (human, bovine and synthetic) into defect areas and stimulate the replacement and growth of new bone for all kinds of needs.  Sometimes the patient's own bone needs to be removed from a site ( the donor site ) and moved to another area of the mouth or face.  We now also have the very exciting new technology to actually create bone, de novo, with the use of synthesized bone growth hormones   ( Recombinant BMP2). Although bone is grafted for a variety of reasons, most bone grafting in our office is now done to provide the right amount of horizontal and vertical bone that will be needed to support dental implants for correct function and esthetic form  Some of the procedures that might be offered are:  

• Sinus lift procedure
  This procedure involves gaining access to the maxillary sinus,  elevating the sinus membrane , and then placing bone graft materials onto the sinus floor.  We can create new vertical bone that will allow implants to be placed in the back part of the upper jaw for crowns, bridges and to support upper dentures.  It is a fairly common procedure in our office.  
• Ridge-augmentation
  When the upper part of the jawbone ridge has been badly resorbed, due to loss of teeth, a bone graft is placed to increase the ridge height and/or width. Sometimes the bone ridge may be  surgically widened so that  bone can be placed between the expanded segments.
•  Socket preservation                                                                                                                                                            When a tooth is removed there has often been bone lost due to infection.  If a dental implant is anticipated then it might be wise to place bone matrix grafting materials into that socket so that bone will replace the missing areas.  When we do that we usually preserve the ridge and wait for about five months to place the implant.  Many types of bone grafting materials might be used for this.  Also- even when bone has not been lost- but we will have to wait for some time to place an implant, it is wise to try and keep that socket from atrophying.  This is a procedure that needs to be done at the time of the extraction.          

These procedures may be performed separately or together, depending upon the individual's condition. There are several areas of the body which are suitable for attaining bone grafts when that is needed  In the maxillofacial region, bone grafts can be taken from inside the mouth, in the area of the chin or third molar region or in the upper jaw behind the last tooth. In more extensive situations, a greater quantity of bone can be attained from the hip or the outer aspect of the tibia at the knee.  These procedures are done in the hospital under general anesthesia.  Most bone grafting, however, is done in our office with packaged materials.  Donor bone from another part of your body is rapidly becoming a thing of the past, and there will probably come a time when all bone grafts are done by placing materials that have been synthesized for just that purpose.  

Why You May Need Extra Support (Grafting) for Upper Back Implants