SURGICAL DENTISTRY

Tooth Extraction
Tooth extraction is one of the most common dental procedures. Healing of the resulting extraction socket normally occurs uneventfully. However, even with completely normal healing, there is often some reabsorption or melting away of surrounding bone. Resulting in less height and width than were present prior to tooth extraction. In addition, as bone resorbs, overlying gum tissue also tends to lose both volume and its normal anatomic form. These changes can occur anywhere in the mouth but the most severe loss of bone and gum tissue tends to occur following the removal of incisor teeth located in the front of the mouth.

The Importance of Bone Preservation Loss of bone and gum tissue following tooth extraction often results in both functional and cosmetic defects: - An unsightly collapsed appearance, especially in the front of the mouth where proper maintenance of tissue health is critical to normal aesthetics.

- It often compromises the dentist's ability to adequately replace the missing tooth or teeth with either conventional removable or fixed bridgework or with a dental implant supported restoration. Sometimes the loss of bone is so severe that additional surgical procedures are required prior to replacing missing teeth.

Bone Grafting
A bone graft is a surgical procedure that replaces missing bone with material from the patient's own body or an artificial, synthetic, or natural substitute is called a bone graft. The graft not only replaces missing bone, but also helps your body to regrow its own lost bone. This new bone growth strengthens the grafted area by forming a bridge between your existing bone and the graft material. Over time your own newly formed bone will replace much of the grafted material.

The need for Bone Grafts
They are needed when a part of your body is missing bone. This missing portion of bone is frequently called a "bony defect". Examples of jawbone defects are: defects which occur following tooth extraction; generalized decrease in quantity of jawbone from trauma or long-term tooth loss; defects surrounding "old style" dental care; defects resulting from cysts or tumour surgery.

Guided Bone Regeneration (GBR)
A procedure in which a membrane is placed over the bone defect site. This membrane encourages new bone to grow and also prevents the in-growth of fibrous scar tissue into the grafted site.

GBR success rate
Recent advances in technology have dramatically increased the success of these procedures, leading to bone formation and resolution of the defect. grafted site. The success rate of bone grafts used to provide support or anchorage for osseointegrated titanium implants is generally quite similar to implants placed in naturally available bone.

Types of Bone
There are many different types of bone grafts. Some grafts are taken from different parts of the patient's own body (i.e. from the hip bone or chin). Other grafts come from deceased human organ donors, from synthetic materials, and from highly purified bovine material.

Likewise, there are different types of GBR membranes. Some are made from synthetic polymers and must be removed during the second surgery several weeks or months later. Other membranes are made of restorable collagen materials.

TYPES OF BONE GRAFT PROCEDURES

Sinus Lift
This procedure involves elevating the sinus membrane and placing the bone graft onto the sinus floor, allowing implants to be placed in the back 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.

Nerve-repositioning
The inferior alveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in the order to make room for placement of dental implants to the lower jaw.

These procedures may be performed separately or together, depending upon the individual's condition.