What is bone plastic?
Osteoplasty relates to surgical operations, allowing you to form the necessary bed for implant implantation. In one case, it is carried out simultaneously with the installation of pins, and in the other is a separate dental procedure. Natural or synthetic materials can be used for the substrate. Mandatory stage - installation Special collagen membrane, which helps in the formation of its own solid tissue in the patient.
Why do osteoplasty need?
The deficiency of bone tissue occurs for a variety of reasons. Most often, this is due to the long absence of dental units. In such a situation, the bone ceases to experience chewing loads and at the time atrophy. The processes begin several months from the moment of the loss of the tooth and continue until the final loss of bone volume.
The degree of resorption of the alveolar process depends on the location. The upper jaw differs less dense structure, so the processes of its shrinkage begin already 2-3 months after the loss of the dentition. Bone tissue extension on the lower jaw may take six year old-year.
Distinguish several types of atrophy:
- Loss of alveolar crest in height;
- Reduction of bone volume in width;
- Simultaneous resorption both in width and height.
Bone plastics allows you to return the jaw bone to the initial state. If you refuse a procedure, an implant doctor will not be able to establish an implant.
Bone Plastic Materials
For regeneration of bone tissue, materials of various types can be used - bone blocks, granules, membranes. Depending on the origin, they are several varieties:
- Autogenous - own patient bone pieces, which can be extracted from the chin and other parts of the jaw;
- Allogeneic - materials of biogenic origin obtained from another person. Usually they are taken after death, subjected to special processing and stored in donor banks. Their advantage - the ability to save the patient from the fence of their own fabric;
- Xenogenic - bone blocks of animals (often - pork or cow);
- Alloplastic - synthetic granulated materials containing calcium phosphate in their composition.
Bone tissue extension methods
To restore the lost bone, five main technologies are used in implantology, which may vary at prices, the area of operation, the operation protocol.
Sinus Lifting
The operation is used to restore bone tissues in the upper jaw. The doctor lifts the bottom of the Gaimore sinus and fills the hole with osteoplastic material. The procedure is carried out when the height of the bone tissue is less than 5 mm. If resorption has an average degree, a sine lifting of the upper jaw and the installation of the implant is simultaneously. The following types of operation distinguish:
- Open - performed by incision of the gums in the side of the jaw and drill holes in the bone. The implantologist uses special tools that help adjust the bottom of the gaimore sinus through the performed hole. Bone material is placed in the created cavity, and then closed the fabric of the barrier membrane and sut the gum.
- Closed is a more sparing procedure because it is carried out without a cut of soft tissues. The hole is drilled directly in the tooth hole, then adjust the bottom and fill the cavity of the bone material. One of the varieties of such an intervention is the balloon technique. The bottom of the sinuses is raised by means of a catheter, which is equipped with an elastic cylinder with saline.
Splitting of alveolar process
This technology is used if necessary to increase the bone on the site of several teeth. An important condition is the presence of horizontal destruction of the alveolar process having a thickness of 2 mm. The operation is carried out as follows:
- The process is cut off longitudinally;
- Expand the resulting cavity through a dental drill;
- Titanium implants are inserted;
- Cavities that remained on the sides of the implants are filled with granulate for osteoplasty;
- Establish a resubbable membrane;
- Sing the gum.
As well as conducting implantation after sinus lifting, the splitting operation of the ridge is carried out simultaneously with the installation of titanium rods. Their enrage leaves from 3 to 6 months. After that, abutments and temporary prostheses are installed.
Bone extension with membrane
Directed bone regeneration is a modern technology that is widely used by surgeons with any degree of degree of alveolar process. The process consists in section of the gums and filling with bone powder (graft), followed by a special membrane. The plate is used to increase the bone both in the width and height. Its main purpose is to keep the count in the gum cavity and warn his contact with the mucous membrane.
Membranes are two types:
- Resorvers - gradually dissolve in the bone and do not require extraction. It is convenient because it is possible to avoid unnecessary cuts, but such a plate will not retain its structure for a long time, so the count does not always have time to take care;
- Non-corrosive - do not resolve and require extraction after the formation of a new bone.
Due to the use of membranes, it is possible to control bone formation processes by limiting it in volume and form. If you need to restore bone tissue with a volume of over 3 cubic meters. mm in height and width, apply a frame membrane that provides additional rigidity for normal recovery. When installing the membrane is fixed by miniature fasteners (Pins), which prevent its offset and contribute to the stabilization of the position.
Curry extension
The author of the technology is the German dentist Curie, which has developed an effective method of bone plastic using the bone block. The material is closed from the patient's chin and is divided into thin plates. The bone section is filled with a graft, the plates on the similarity of the roof of the house are installed on top. Fixation of osteoplastic material is carried out using titanium screws. In completion, embed the gums.
The technique is not used for simultaneously installing implants. To put implants, it is necessary to wait for fabrics (on average to six months). The operation is characterized by efficiency and gives a long-term result, but has the same disadvantage that is characteristic of all technologies using the bone block, namely, trauma.
Osteoplasty bone block
The technique is relevant to restore large bone volumes. It is used when the lack of bone tissue is observed both in height and in width. The bone block is extracted from the chiffer area of the person or the angular part of the lower jaw. The cavity in the gum is filled with the material obtained, then the gum is invented.
As in the case of the Curie technique, the procedure is carried out in two stages. Osteoplasty is performed on the first, and after about half a year implants are installed. The use of a "native" bone increases the likelihood of successful regeneration, since the body does not give an immune response to its own tissues. A person does not need to worry for extracting its material, since the operations are preserved with bone walls, that is, the bone in this place is restored over time.
In some situations, you can do without performing osteoplasty. But then the patient will have to put the implants of another type (zilly or basal). The procedure may be more complex in comparison with osteoplasty.
Rehabilitation recommendations after bone extension
The rapid reduction of bone tissue during implantation is largely depends on the patient. It must accurately comply with the instructions of the surgeon, which will avoid complications and have a positive effect on treatment. During rehabilitation follows:
- Avoid stress, physical exertion;
- Do not include solid products in the diet (they may injure the bone and lead to the development of infection);
- Taking antibiotics and anti-inflammatory drugs assigned by a dentist;
- Eliminate overheating (bath, sauna) and supercooling of the body.
