Bone grafts

In oral surgery, the skilled reconstruction of the alveolar process (the part of the jawbone in which a tooth is embedded or a dental implant is to be placed) to improve or restore the prosthetic base is of great importance.

The indications for bone grafting are: 

• post-traumatic loss of alveolar process, 

• tooth extractions with significant damage and subsequent bone loss, 

• alveolar atrophy due to ageing processes, osteoporosis or genetic defects. 

Whatever the cause of alveolar bone atrophy, the methods used are aimed at restoring chewing function and improving the patient's aesthetics. 

There are absolute indications for the reconstruction of an atrophied alveolar process, in the absence of a correct foundation for the dental implant and prosthetic reconstruction procedure. 

The minimum alveolar dimensions required for proper implant placement are: in the vertical dimension more than 10 mm, in the transverse dimension more than 6 mm. 

Bone reconstruction may also be necessary when the height of the prosthetic structure (implant-supported teeth), exceeds the height of the vertical anchorage of the implant in the bone, and when significant loads are anticipated (e.g. restoration of the entire dental arch with a prosthetic bridgeconsisting of 12 teeth, supported by 4-8 implants). 

In some cases, prosthetic reconstruction, only aesthetic indications determine the need for bone and soft tissue reconstruction. 

The restoration of advanced alveolar atrophy over a large area is one of the main indications for autogenous bone grafting, prior to the placement of dental implants. 

• An autogenous bone graft is the patient's own bone, taken from an area of low aesthetic importance and then placed in the deficient alveolar region where the implant is planned. The patient's own bone is the best material for augmentation of the atrophied alveolar process. 

• We obtain cortical bone from places such as the mandibular branch - behind the last molars or on their lateral side, the chin or the area around the cusp of the jaw. In extreme cases, very extensive atrophy, the graft is obtained from the hip bone plate. However, this is a very invasive method. 

• The bone tissue harvested for transplantation is in the form of blocks or bone chips. 

• The use of a piezoelectric surgical device to cut bone is invaluable in this procedure (Piezosurgery). 

• The bone blocks obtained are given the desired shape and fixed with titanium micro screws, and larger pieces with titanium micro plates, in areas of alveolar atrophy. 

• In the reconstructed area, implantation is performed after a period of 4-12 months, into integrated and vascularised bone. 

Very good therapeutic results are obtained by using ADDITIONAL biomaterials around the transplanted bone (Bone regeneration using biomaterials)