Progressive methods. Caring approach.




While dental implants can work wonders to improve both the appearance and health of your smile, there are many ways in which your jawbone may be structurally insufficient to handle the implants. When this happens, we turn to bone grafting to strengthen your bone structure to handle the implants.


Modern technology allows us the ability to grow bone where needed. This not only will allow us the opportunity to place the proper implants where they are needed — it also restores both functionality and esthetic appearance.


Major bone grafts are typically performed to repair jaw defects that may have been caused by traumatic injuries, surgeries or congenital defects. They typically require using the patient’s own bone for the graft. Using one’s own bone in a graft procedure is typically the most effective and successful option, though there are other options for some procedures. Major grafting procedures are typically performed in an operating room and require a hospital stay.

The bone used for grafting is typically obtained either from a tissue bank or from your own jaw, hip or tibia. Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes can be utilized that dissolve under the gum, protecting the bone graft and encouraging regeneration. This is called guided bone regeneration or guided tissue regeneration.


There are various methods that can be utilized to graft bone. The approach taken depends on your specific situation. At 6th Avenue Periodontics & Implant Dentistry, Dr. Roya Niakiani is prepared to craft the approach best suited to your needs. Contact us today to learn more about this and other services we offer in our state-of-the-art downtown San Diego office.


1. Sinus Lifts — This procedure is undertaken when the bone barrier between your teeth and the maxillary sinuses, located behind your cheeks and above your upper teeth, is too thin. Dental implants need bone to hold them in place. It is not possible to place dental implants in this bone if it is too thin. During a sinus graft (also known as a sinus lift graft) a surgeon inserts bone into the floor of the sinus. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone. Sometimes, the implants can be implanted in the same procedure. Sinus grafts now make it possible for many patients to have dental implants when, years ago, there was no other option besides wearing loose dentures.


2. Ridge Expansion — This is a technique used to restore the lost bone dimension when the jaw ridge, located between the upper teeth and the hard palette, becomes too thin to receive conventional implants. In this procedure, the bony ridge of the jaw is expanded mechanically, allowing for a bone graft to be placed. Once it matures, the implant can be placed as well.


3. Nerve Repositioning — In some cases, the nerve which provides feeling to your lower lip and chin may need to be moved to allow for the placement of an implant in the lower jaw. This procedure is limited to the lower jaw and is considered a very aggressive approach, resulting in post-operative numbness that may never go away. Because of this, other less aggressive options are considered first.In this procedure, your surgeon will remove a portion of the jaw bone, exposing the nerve and vessel canal. The nerve and vessel bundle are then moved slightly to the side. The implants may then be placed in the same procedure. Bone graft material is necessary to close the area. This is sometimes done as a separate procedure.


These surgeries are performed under IV sedation or general anesthesia. After discharge, bed rest is recommended for one day, and physical activity must be limited for a week.


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