In addition to the implant surgery, you may need other surgical procedures to ensure the success of your implant.
For an implant to be successful, it must osseointgrate with your jaw bone. This is the process where your bone tissue grows into the implant to anchor it firmly into your jaw.
For good osseointegration to occur, the implant needs to be surrounded by adequate amounts of healthy bone.
For the implant to survive long-term, it needs to have a thick healthy soft tissue envelope (gingiva) around it.
If either the bone or soft tissue is found to be deficient, the practitioner will need to reconstruct the affected tissue either before or during the implant placement.
Soft Tissue Regeneration
For an implant to look aesthetically pleasing and remain viable over the long term, a band of full, plump gingiva is needed to fill in the space on either side of the implant.
The most common soft tissue complication is called a black-triangle, where the papilla (the small triangular piece of gum between two teeth) shrinks back and leaves a triangular void between the implant and the adjacent teeth.
If the gum is very thin and lacking, it can be recreated with a soft tissue graft. There are several methods that can be used to transplant soft tissue, with the donor site usually being the palate.
Dr Chan always strives to preserve and build up the papilla whenever possible throughout the whole treatment process.
Bone Regeneration (Bone Grafts)
Bone regeneration is necessary when there is insufficient jaw bone to accommodate the osseointegration of the implant.
Dental implants need bone to hold them in place, and they in turn stimulate the bone so it can remain stable.
The most common cause of bone loss is the long term (several years) use of a denture or partial denture. When missing teeth, the jaw bone will slowly “melt” away over time from the lack of direct stimulation. The continued irritation of the denture or partial denture further exacerbates this loss.
Disease or an accident can also leave a larger hole than desired for dental implant placement. If this hole is left to heal on its own, 25% of bone will be lost in three months. At six months, 50-60% of the bone will be lost on average.
The deficit can be made up with the following types of bone regeneration procedures.
Socket Bone Regeneration
The site is filled particles of a bone substitute and allowed to heal. In most cases, Dr Chan can place the dental implant and bone particles at the same visit as the extraction.
Guided Bone Regeneration
This technique is often used when the bone has lost width and/or when only a moderate amount of bone has been lost.
The deficient site is packed and shaped with either your natural (harvested or autograft) bone, animal bone or a synthetic bone substitute (donor bone or allograft.) It is then covered with a semi-permeable membrane. The gums are then stitched over this membrane.
Your natural bone will eventually grow into and replace the grafts.
Block Graft Regeneration
In moderate to large bone deficits, or when the jaw is too thin, block grafts are usually recommended.
Bone can be transferred from the wisdom teeth area or chin, with the former being more common.
The transferred bone is secured to the site of the deficiency and will become attached to the site in four to six months, ready to accept an implant.
The donor site will also heal completely. The bone lost to harvesting typically regenerates in less than a year.
Safe and Sterile Natural Bone Products
All natural bone products are treated by multiple sterilization methods to eliminate the bacteria, viruses and foreign proteins, making them a suitable universal donor material.
Countless research papers and clinical studies have shown them to be safe, even for people with multiple allergies and sensitivities.
We import our bone products from the USA or Sweden. These are approved by the Australian Therapeutic Goods Administration.
Some of the roots of your upper teeth extend up into the maxillary sinuses. These are located behind your cheeks and above your upper teeth.
When the available bone is very thin, it is impossible to predictably place dental implants into the upper jaw bone.
A sinus regeneration or sinus “lift” procedure aims to increase the amount of bone separating the floor of the sinus from the upper jawbone.
Sinus Regeneration Procedure
There are various techniques, developed for differing situations.
Prior to undergoing sinus regeneration, diagnostics will be run to determine the health of the patient’s sinuses.
Panoramic radiographs and CT scans are studied to measure the sinus’s height and width, and to rule out any sinus disease.
An incision is made through the gum of the upper jaw, exposing the lateral bony wall of the sinus. The surgeon then cuts a “window” to the sinus, which is covered by a thin membrane. This membrane is carefully lifted up, and bone graft material is placed into the newly created space.
It takes about six months for the sinus regeneration bone to become part of the patient’s natural sinus floor bone. The implant surgery can then proceed.
In some situations, Dr Chan can perform both the regeneration and dental implant simultaneously.