Implant treatment in bone deficiency

Implants > Implants in bone deficiency

A healthy smile

In order to place implant-supported teeth in a healthy and appropriate way, at least 1 mm of tissue is required around the implant. Therefore, bone support of sufficient width and length is needed to make long-lasting implants.

There are two basic processes used to determine the bone level:

Clinical examination by a knowledgeable and experienced physician.

3D imaging with dental volumetric tomography, where we can see all the anatomy that cannot be detected in clinical controls and even during the operation.

If it is determined that there is not enough bone in the jaw to make a healthy prosthesis, new bone can be created by applying different techniques in the lower or upper jaw, or by using the right prosthetic solution such as angled implants with the Fast & Fixed technique.

New bone-building techniques include:

Sinus lift technique

If there is no bone in the posterior regions of the upper jaw, new bone formation can be achieved in the sinus region in the vertical direction.

Split osteotomy (sandwich technique)

It is a technique in which the implant is placed between the bone by opening it like a sandwich in insufficient bone thicknesses.

Block bone formation technique

It is applied by taking a block of bone from the back of the jaw or hip and placing it in the area with inadequate bone support for the implant.

Box technique

It is applied with artificial bone materials and thermoplastic moulding technique.

Maxillary sinus lift

Sinuses are air spaces in the upper jaw above the posterior molars. The sinuses can cause the bone around these molars to recede overtime, making it difficult to apply the implant in this area. For this reason, sinus operations can be performed. These require a high level of accuracy and dental experience.

Using a surgical technique known as a “maxillary sinus lift,” surgeons can increase the bone thickness between the gum and the floor of the maxillary sinus.

Sinus lift operations are divided into two procedures; open lift and closed lift.

If there is not enough bone to retain the implant, the process of creating new bone formation by raising the sinus with the help of appropriate hand tools through the mouth without the need to open a side window is called closed lift. In cases where closed lift is applied, the implant procedure can be performed in the same session. Bone powder or PRF (concentrated blood containing growth cells) can be used for bone formation.

In an open lift procedure, bone formation is created by opening a window from the side wall of the sinus. If sufficient retention is provided, the implant can be applied in the same session. In cases where further retention is needed, the waiting time is often 6 months.

The main purpose of sinus surgeries is to increase the bone volume under the sinus with bone-forming materials without damaging the sinus anatomy. Thus, when the bone formation in the area matures to an adequate level, a successful implant can be applied to this area. In some cases, if there is bone in the areas adjacent to the sinus cavity, an angled implant can be placed and treated without the need for a sinus operation. If there is little bone under the sinus cavity, the need for sinus operations may be eliminated by using short implants.

Frequently asked questions about maxillary sinus lift

What is sinus augmentation?

The anatomical spaces above the teeth in the posterior region of the maxilla are called maxillary sinuses. In cases where the maxillary sinus volume is large or the bone volume in the posterior teeth area is reduced, (often due to extraction of posterior teeth), it may not be possible to implant in these areas. Considering that the most important factor in implant treatment is high quality, thick and high bone, this creates a disadvantage in terms of implant surgery. In such cases, a procedure called "sinus augmentation" or "sinus lifting", which is the process of raising the sinus floor, is performed using bone grafts.

How is sinus augmentation done?

It is the process of placing bone grafts (bone powders) between the jawbone and the sinus mucosa under local anaesthesia. After the operation, the bone graft fuses with natural bone over a period of 6 months. In some cases where the bone height is relatively sufficient, implants can also be made in the session where the grafts are placed.

What should I pay attention to after sinus augmentation?

Food should not be eaten until the numbness is gone (as the cheek or lip in the numb area may be bitten without being aware of it).
Hot baths should not be taken for the first 24 hours.
Hot foods and beverages should not be consumed.
Antibiotics, painkillers, and other medication given by the physician should be used regularly after the operation.
Ice compress should be applied to the operative area over the face to prevent swelling after the operation.
After the operation, the mouth should not be rinsed with water. A straw should be used for at least ten days, and smoking should not be allowed. Situations such as sneezing, and coughing should be avoided. After the operation, the nose should not be cleaned with pressure and water should not be taken into the nose.
Teeth can be brushed 24 hours after the operation.

Do you have any questions or want to start your treatment?