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Bone is missing – what next?
There are not so many different answers to any other question as from the field of implantology. There is no arguing about that lost bones have to be regenerated but we find a lot of different procedures depending on the kind and complexity of the defect and its location. Other factors also play an important role in regenerating the bones, e.g. age, general diseases, hormonell factors and the way you live.
Finally, there are pyschological influences, especially if the question arises whether tranplants naturally produced in the body or material from outside should be used. We decide in every single case what has to be done.
Build-up of lateral defects of the ramus mandibulae
Lateral defects can be regenerated, according to the individual situation, before or during the implantation. Transplants produced in the body (e.g. splinters from the implant drilling) as well as material from outside (tri calcium phosphate)and membranes can be used.
Alternatively, the implant bedding can be supported by widening and extending preparation work in such a way that the healing process will be stabilzed without further build-up.
Build-up of the lateral upper jaw area (sinus lift)
The so called sinus lift is an operative procedure to raise the upper jaw in the area of the molar teeth. Especially in this area, there are different anatomical variations and frequently situations after the loss of teeth which have reduced the jaw bone and which require the build-up of the implant bedding.
The mucous membrane of the maxillary sinus will be lifted first during the surgical procedure and later the chosen build up material is added. This can be done either if a local or a general anesthesia is given. There is less pain compared to a normal tooth extraction but swellings can be more intensive. Complications are minor and very rare.
According to the individual situation, the implant is placed concurrently or after an interval of two months in a second procedure. In this case, the waiting period for the definite care is longer but it guarantees greater safety if the implant is placed after a successful regeneration of the jaw.
Absolute elevation of the jaw by transplates
The absolute elevation of the jaw is one of the most demanding surgical procedures in reconstructing the frame of the prothesis, respectively of the implant. Transplants produced in the own body are preferred. If only little material is needed, we can get it in the operational area (see below).
The x-ray shows the construction of the jaw including bones taken from the hip and four implants fixing the prothesis.
Distribution of the callus -
a new procedure offering new prospects
The so called distribution of the callus was established before for the extension of arms and legs and is now used as a modern procedure to reconstruct the ramus of mandible.
The advantage of this procedure is that transplants are used which do not have to be produced in the own body . A disk for extension is used which enables the ramus of mandible to be stretched continuously . The disadvantage of this procedure is longer and more intensive after care treatment. 0.5-1.0mm are stretched daily until the required hight of the jaw is reached (10-14 days). After another 8-12 weeks the extension disk will be removed and the implants are placed.
