Hospital Dent Report

7/29/2019 Hospital Dent Report

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Bone Graft and Tissue Transplantation inDental Implants

Mark D. Dublin


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+Definition of Terms

Dental implant - is a "root" device, usually made of titanium,used in dentistry to support restorations that resemble a tooth or

group of teeth to replace missing teeth.

Bone grafting - is a surgical procedure that replaces

missing bone in order to repairbone fractures that are extremelycomplex, pose a significant health risk to the patient, or fail to heal

properly.

Transplantation - to transfer (tissue or an organ) from one body

or body part to another.

Gingival graft - is a generic name for any of a number of

surgical periodontal procedures whose combined aim is to cover

an area of exposed tooth root surface with grafted oral tissue.
http://en.wikipedia.org/wiki/Bonehttp://en.wikipedia.org/wiki/Bone_fractureshttp://en.wikipedia.org/wiki/Periodontalhttp://en.wikipedia.org/wiki/Toothhttp://en.wikipedia.org/wiki/Medical_graftinghttp://en.wikipedia.org/wiki/Medical_graftinghttp://en.wikipedia.org/wiki/Toothhttp://en.wikipedia.org/wiki/Periodontalhttp://en.wikipedia.org/wiki/Bone_fractureshttp://en.wikipedia.org/wiki/Bone


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+Bone Graft

Bone grafting is the most common surgical dental

procedure associated with dental implants. It is vital

that dentists placing dental implants be proficient at

bone grafting techniques or knowledgeable enough to

diagnose them and refer the patient to an oral surgeon

to have that particular procedure done.

The most important requirement for a

successful dental implant and bonegrafting procedures is the presence of enough bone

height and width to support the implant.
http://dentaldynamicsonline.com/services/dental-implants/types-of-dental-implantshttp://dentaldynamicsonline.com/services/dental-implants/types-of-dental-implants


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The most common use of bone grafting is in the application

ofdental implants, in orderto restore the edentulous area of a

missing tooth.

Dental implants require bones underneath them for support and

to have the implant integrate properly into the mouth. People whohave been edentulous (without teeth) for a prolonged period may

not have enough bone left in the necessary locations.

In this case, bone can be taken from the chin or from the pilotholes for the implants or even from the iliac crest of the pelvis

and inserted into the mouth underneath the new implant.
http://en.wikipedia.org/wiki/Dental_implantshttp://en.wikipedia.org/wiki/Edentuloushttp://en.wikipedia.org/wiki/Osseointegratehttp://en.wikipedia.org/wiki/Edentulismhttp://en.wikipedia.org/wiki/Edentulismhttp://en.wikipedia.org/wiki/Osseointegratehttp://en.wikipedia.org/wiki/Edentuloushttp://en.wikipedia.org/wiki/Dental_implants


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+Types of dental bone grafting procedures

related to dental implants

Socket preservation

Ridge augmentation


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+ Socket preservation is where the bone is placed in the tooth

socket after extraction to preserve the height and width usually

for future dental implant.


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+ Ridge augmentation refers to the process of rebuilding theheight or width of the jaw bone or both to allow for a future

dental implant. This procedure is usually performed in areas

with considerable bone loss.


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+Connective tissue and mucosa tissue

transplantations

used in dental medicine to treat gum tissue deficits especially in

those areas connected with aesthetics.

In contrast to a mucosa transplant connective tissue

transplantation also includes transplanting the subcutaneous

connective tissue.

The volume of the connective tissue transplant remains stable

after the transplant and does not shrink. Therefore, it is

commonly used to fill out areas with thin or little gum tissue.


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+Typical Indications for Mucosa

Transplantation

Root exposure after recession (gum tissue recession)

Filling out and forming of jaw area which have deteriorated

while also providing an aesthetic treatment

During a vestibule plasty which is used to increase the size of

the oral vestibule


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+Periodontal Tissue Grafts

Periodontal gum tissue grafts are an important part ofimplant

dentistry. There is two types gum tissue around teeth. Thick gum

tissue immediately surrounds teeth and is referred to as

(keratinized gum tissue) or (non-mobile gum tissue) or (keratinized

gingiva) and thin tissue that lies close to the floor of the mouth that

is referred to as (non-keratinized gum tissue) or (mobile gumtissue) or (non-keratinized gingiva).


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This thick tissue is vital to the health and longevity of

teeth. Loss of the thick keratinized tissue is referred

to as gum recession or gingival recession. When

that happens, the lost tissue must be replaced. Lossof keratinized tissue is common with dental

implants as it is a common consequence of tooth

loss.


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+Methods and materials utilized in

tissue or gum grafting

Connective tissue grafts

Free gingival grafts

AlloDerm tissue graft

Periodontal tunnel grafts or periodontal tunneling surgery

Growth Factors PDGF and Periodontal Tissue Grafts

Placental tissue for periodontal tissue grafts


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+Free gingival grafts

The grafted tissue is taken from the outer surface of the roof of

the mouth and grafted to the deficient site.


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+AlloDerm tissue graft

AlloDerm is donated skin Allograft material from other humansthat is processed to produce a dermis layerthe deeper layer of

the skin. The main advantage of AlloDerm grafts is less

healing as there is no donor site at the roof of the mouth.


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+Periodontal tunnel grafts or

periodontal tunneling surgery

Grafting gum tissue with tunneling techniques is a part of the

latest development in periodontal gum microsurgery

techniques also referred to as periodontal plastic

microsurgery. It is well understood that less invasive surgery

would lead to less disruption to blood supply and in turn faster

wound healing and more predictable results. Several variations

of this method have been developed, these methods are

referred to as modified periodontal tunneling surgery or

modified periodontal tunnel grafts.


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+Growth Factors PDGF and

Periodontal Tissue Grafts

In certain cases growth factors can be used along with gum

grafting. The most utilized is PDGF platelet derived growthfactors.PDGF can promote the regeneration of periodontal

tissue and healing. There are several techniques utilized in

incorporating PDGF growth factors into periodontal tissue

grafts.


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+Placental tissue for periodontal

tissue grafts

The most recent innovation in periodontal and gum tissue is theutilization of placental tissue. It is thought to produce lessinflammation than other donated allograft materials currentlyused.

Before Sinus lift Sinus lift and dental

implants placement


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+Sinus Lift

Sinus Lift is the process where the sinus membrane isrepositioned to allow for a space where bone is grafted to

support a dental implant. Sinus lift is a very predictable

procedure that can increase bone height and width. In most

cases the dental implant(s) is placed along with the sinus liftprocedure.


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+Types of Bone Materials Used In

Dental Bone Grafting

1. Autografts:

2. Allografts:

3. Xenografts:

4. Alloplasts:


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+Autografts

The bone comes from the same patient person, while the

recipient site is the jaw, the donor site can be part of mandible

or hip.


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+Allografts

Bone that comes from other humans, usually processed

cadaver bone in the form of small granules or small blocks.


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+Xenografts

Bone from another species, most commonly from cows


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+Alloplasts

Synthetic bone material. Material that is manufactured.


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+Bone Grafting Is Not Appropriate

If dental implant bone grafts, bone growth, or bone expansion will not

provide sufficient support for a dental implant, the patient may have to

have a mold taken of his or her jawbone and a plate inserted to holethe implants.

If you have plenty of bone tissue and the gums and teeth surrounding

the area where you want a dental implant are healthy, then you may

not have to concern yourself with dental implant bone grafts

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