Inadequate bone structure in the upper and/or lower jaws can be a result of injury, ablative tumor surgery, long-term denture wearing. Loss of the jaw can be devastating to appearance and to function. Reconstructive surgery is performed on abnormal structures of the body, caused by birth defects, trauma, infection, tumors, or disease (acquired deformities). You may also call it corrective bone surgery. It is generally performed to improve function, but may also be done to approximate a normal appearance. Modern treatment options allow maxillofacial surgeons to achieve improvements in form and function thought impossible just a few years ago. Through oral reconstructive surgery, a solid foundation can be provided for dental rehabilitation, which in turn aids nutrition and speech.
Reconstruction of jaw structures and preparation of hard and soft tissues is often compulsory for dentures, bridges, bone grafting, implant placement. In many cases reconstructive surgery is necessary before implant placement procedure when bone augmentation is necessary to allow the proper positioning of implants and assure the best outcome. These procedures may be performed separately or together with dental implant placement.
Reconstructive surgery frequently demands complex planning and may require a number of procedures done in stages.
Preoperative diagnosis and planning for patients with jaw asymmetries and deformities includes a photographic analysis and a complete orthognathic work-up involving cephalometric and panorex radiographs, dental impressions, and models.
Reconstructive dentistry incorporates a variety of advanced dental procedures that employ state of the art materials and technologies. Successful use of these methods requires precision attention to detail and true creative talent that only a well tenured dentist can perform.
Bone Grafting
Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants. This not only gives the opportunity to place implants of proper length and width, it also gives a chance to restore functionality and esthetic appearance. The bone graft procedures are referred to as:
Sinus lift procedure
This procedure involves elevating the sinus membrane and placing the bone graft onto the sinus floor, allowing implants to be placed in the back part of the upper jaw.
Ridge-augmentation
In severe cases the ridge has been reabsorbed and a bone graft is placed to increase the ridge height and/or width. In other cases, a technique called osseodistraction can be used to increase ridge height.
The bone grafting procedure generally consists of following stages:
- The tooth socket which underwent bone loss after tooth extraction is thoroughly cleaned of all iflammed and infected tissue if it is presented and a proper access to the socket is made.
- An appropriate bone grafting material is carefully placed into the extraction socket.
- Sutures placed into the gum tissue allow proper healing of the surrounding soft tissues.
Osseous grafts using either autologous bone or bone substitutes can be performed to improve both the quantity and quality of the hard tissue. Skin grafts and soft tissue corrections can be utilized to improve the architecture of the intraoral soft tissues. There are several areas of the body which are suitable for obtaining bone grafts. In the maxillofacial region, bone grafts can be taken from inside the mouth, in the area of the chin or third molar region or in the upper jaw.
Nerve- repositioning
The inferior alveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in order to make room for placement of dental implants to the lower jaw.
All these surgeries are performed in our outpatient surgical center under I.V. sedation.
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