By Karl-Erik Kahnberg
This ebook explores the possibility of bone grafting thoughts to rehabilitate the maxilla during the placement of dental implants. As implant dentistry turns into more and more good demonstrated and complicated, this ebook might help skilled surgeons to contain implant ideas as a part of tougher reconstructions within the higher jaw.Starting with a recap on ideas of bone biology, the publication then considers implant integration in basic bone and with bone grafts. Grafting tactics are provided depicting quite a few bone harvest websites, via onlay and inlay grafting concepts. methods to sinus lifting, segmental osteotomy and distraction osteogenesis for augmentation protocols are supplied.
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Additional info for Bone Grafting Techniques for Maxillary Implants
2 Nasal inlays. 3 The nasal mucosa in the nasal aperture is carefully lifted. 4 Bone graft is pressed into the nasal cavity below the nasal mucosa. 5 The bony height of the alveolar process increased by 5–6 mm. 6 The nasal inlays combined with onlay grafts on the thin alveolar crest. 2 Maxillary sinus grafting (sinus lifting) Implant treatments of the edentulous posterior maxilla occasionally meet with problems due to the lack of bone volume beneath the maxillary sinus cavity. Resorption of the alveolar process after loss of posterior teeth support can proceed either from the oral side or by expansion of the sinus cavity into the alveolar process, or both.
As always, careful prosthetic loading both during healing and within the ﬁrst six to twelve months after abutment connection is a prerequisite for the success of the ﬁnal outcome. However, long-term followup has shown that there is a remarkably good preservation of the bone volume. Onlay grafting methods do have their place in the rehabilitation of implant patients especially if there are large bony defects in the alveo23 Onlay bone grafting lar process or localized traumatic loss of part of the buccal or lingual ridge.
The graft material may consist of both cortical and cancellous bone and may also be milled to form a particulated bone material. This bone material can then be mixed with artiﬁcial bone material up to a 50 : 50 ratio without affecting the healing process and bone formation. If only a little graft material is needed, small bone graft particles can be ‘nibbled’ from the neighbourhood of the surgical site. Collection of bone material during drilling of ﬁxture sites by using the BoneTrapTM 33 Inlay bone grafting has also proven to be very efﬁcient, with remarkably large amounts of bone powder material being collected.