Planning for implant placement should ideally begin before the extraction. A traumatic extraction prevents further loss of bone and tissue by using special instruments like periotomes, Piezo Electric tips etc. We utilizes these techniques on a routine basis.
In a conventional removal of a broken or carious tooth involves cutting of the bone around the tooth. Preserving this bone is critical during extraction. Every bit of bone and tissue which is preserved helps in proper placement of dental implants. It is hard to regenerate the bone if it is lost in its height.
Piezo Electric tips with acoustic effects of vibration loosen the teeth with in the bone without cutting away the bone. Periotomes can be inserted in the periodontal ligament to loosen the teeth. These are some of the atraumatic techniques which are being utilized at our clinic.
Studies have shown that by performing bone grafting immediately after the extraction of tooth not only prevents the initial rapid shrinkage of bone but in some instances regenerate some of the lost height as well. This is extremely important planning in implant dentistry and goes a long way in successful implants.
In some situation where the tooth has been lost for a long time, there is deficient bone width and height. In such situation bone graft is performed.
Usually Bone graft is performed with collagen membrane and particulate bone materials derived from human or animals. However in some situation depending upon the complexity of case following techniques are utilized:
Tenting screws are utilized to provide extra support to collagen membrane and hence it prevents the collapse of the membrane. This way one can achieve greater and more predictable regeneration of bone height which is hard to achieve.
Because Titanium meshed membrane has a memory it stays in desired shape and hence one can achieve predictable regeneration in desired directions.
Tacking screws prevents micro movement of collagen membrane and hence the regeneration can be achieved with out any complications like exposure of the membrane.
In some situation it would be best to harvest the patients own bone either from chin or back portion of jaw.
Enhances and stimulates the cells of our own bone.
It is a technique where outer and inner side of jaw bone is separated so that grafting can be done in between the core of the bone and in some situation simultaneous implants placement may be possible.
There has been great advancement in sinus lift techniques. After the tooth removal in upper jaw our maxillary sinus which is a hollow structure sitting inside the bone starts migrating downwards and over the time there is very little bone available to place implants. With the sinus lift techniques the floor of the sinus is raised and hence it is possible to place the dental implants.
Sinus lift is performed in several ways. Conventionally a drill is used to cut a window to expose the sinus. It has been found that a good 40% of cases end up with a complication of sinus membrane tear. With the advent of Piezo Electric techniques there are less complications. At Valley Periodontics and Dental Implants, we utilize piezo electric and the most conservative way of lifting sinus membrane.