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BONE AUGMENTATION

Foundation for stable tooth implants.

Just like when we build a house, we need a stable foundation (= jawbone) in implantology to be able to supply you as a patient with tooth implants safely.

Long-term edentulism (toothlessness), periodontitis or inflammatory processes can cause the jawbone to deteriorate. A so-called jawbone augmentation (bone augmentation) can thus ensure safe anchoring of the implant. Scientifically tested and clinically proven bone replacement materials are used to restore bone in the jaw.


Frequentley asked questions

Where do we harvest the autologous bone?

In principle, your own bone, i.e. a bone graft taken from you (autologous bone block or bone shavings) is the best bone graft material we can use for bone augmentation. Autologous bone can be harvested at various site in the jaw region without any negative consequences. In the lower jaw, typically the wisdom tooth region is used. A suitable piece of bone is harvested and grafted to the area of with the defect. Subsequently, this is covered with an artificial membrane to ensure optimum healing.

Is it necessary to harvest autologous bone?

By using modern bone graft substitute materials (which are later replaced by your own bone), harvesting autologous bone, e.g. from the hip, and thus creating a second surgical site can often be avoided.

What is the alternative offered by graft substitute materials?

Modern resorbable bone graft substitute materials offer the alternative:

  • No additional harvesting of bone from the pelvic/hip bone or lower jaw
  • Operating time and surgical risk are reduced to a minimum
  • Faster wound healing and shortened treatment times 
  • Resorption of the substitute material and at the same time formation of vital bone 

Are there any disadvantages compared with autologous bone?

Using special resorbable bone graft substitute materials, we can regenerate vital and responsive bone with the same characteristics as your own bone. The aim is to regenerate defense-competent bone which represents the ideal environment for safe implant placement.

What exactly are CAD/CAM-milled bone blocks?

Modern bone graft substitute materials are available as particles or bone blocks. Using a scan of the jaw defect (CT or DVT scans) and powerful planning software, bone blocks are created virtually. Subsequently, the actual bone graft is cut from the bone block under clean room conditions. The trailer-made bone block is then placed and fixed in the jaw. A resorbable collagen membrane between bone block and soft tissue promotes optimum healing. 

What are the benefits of 3D bone blocks?

The benefits derived from a tailor-made bone block, modern computer technology and perfect craftsmanship are huge. We are able to place permanently fixed implants at sites where the condition of the natural bone would not allow it. Operating times are tremendously shortened. This is a remarkable progress.


Methods and techniques

Ridge Preservation

At the time of the extraction the stage is set!   

Every extraction socket shrinks during healing. But the preservation of the bony structures and gums plays a crucial role in achieving an esthetic and predictable outcome. Therefore, everything must be done at the time of the extraction to avoid a collapse of the extraction site.

When, with what and how does the extraction take place? Will a socket/ridge preservation be used, i.e., will we place filling material in the socket? Can we improve the soft tissue? Which procedure will be performed? Implant or bridge? For an implant treatment, another procedure is selected for tooth extraction than for a bridge procedure.  

Suitable management of the extraction socket is worthwhile. We establish more stable conditions for your dental care, and follow-up procedures (e.g. bone restoration) can usually be minimized. 

Sinus lift

Standard procedure in the posterior region.

The sinus lift (sinus floor elevation) is a surgical procedure for the restoration of jawbone in the posterior upper jaw. Your own bony layer of the maxillary sinus floor will thus be thickened to enable sufficient stability for a tooth implant. 

Usually the implant can be inserted at the time of the sinus lift. 

With a sinus lift we differentiate between a direct procedure (orthograde sinus lift) and an indirect procedure (lateral sinus lift). Here, only the approach to the maxillary sinus differs in order to insert bone replacement material at the implantation site.

The sinus lift should be regarded as a routine treatment in implantology with a very high success rate and a very low complication rate.

GBR technique

Guided bone regeneration.

Guided bone regeneration (membrane technology or GBR technique) is jaw-bone augmentation procedure – before or during the implantation. 

Here, an artificial collagen membrane surrounds the area to be filled with bone. Bone cells migrate from the surrounding tissue and form firm bone. Bone graft substitute serves the cells as a lead structure into the bone defect.

Using the GBR technique (Guided Bone Regeneration), bone regeneration is achieved. The initial condition of the jaw will continue to be rebuilt and tooth implants can be stably and predictably inserted.

PRF

The turbo of wound healing.

The new procedure to accelerate initial wound healing. Endogenous factors, fibrin and platelets can be obtained from the blood and used in bone augmentation. 

Using a simple withdrawal of blood and a special centrifugation process, the number of cells, platelets and growth factors can be greatly concentrated. 
This concentrate is mixed into the bone graft substitute. Cells and growth factors are now already in place and no longer need to migrate to the operating field.
The result: significantly accelerated healing!

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