A ridge augmentation is a surgical procedure for patients whose jaw is not wide or tall enough to support dental implants. This frequently happens, for example, when there have been several missing teeth for a period of time, causing bone destruction or deterioration, although denture wear and trauma can also cause or exacerbate the condition.
The procedures attempt to restore the natural contour of the bone resorption (melting away) and make it possible to safely and properly place dental implants that will be long-lasting.
After an examination of your mouth, teeth, and gums, Dr. Singer will give you options to help you determine the best technique for your ridge augmentation. The images rendered by the iCAT 3D cone beam scan are vital to seeing the bone and important structures of the jaw.
An incision is usually made along the crest of the ridge of the jaw (top) so that the space can be created. Bone grafts are then placed in the deficient areas to rebuild the shape of the gums and jaw. The bone graft is typically covered with some type of membrane, and sometimes a titanium mesh will be used or even implants to maintain a tent space. The important biologic principle is to keep the bone graft material stable and preserve a space for it to keep the soft tissue from invading the graft as it is replaced with new bone. The gum tissue is then replaced and sutured.
In some cases, the dental implants can be placed immediately during the ridge augmentation procedure, but in a number of cases, the ridge augmentation must heal for several months before the dental implants can be placed. This allows any bone grafts time to fuse to the existing bone in the mouth and for new bone to form.
Bone grafts are sometimes harvested from another part of the body, such as the chin or posterior lower jaw. Donor bone can also be sourced from human donors, bovine, equine, porcine or synthetic materials. All forms are rigorously prepared through intensive processes to ensure safe use and have been approved by the FDA. Similar techniques and materials were pioneered by and continue to used by orthopedic surgeons.
A significant amount of bone may be required for a ridge augmentation, which could necessitate harvesting bone from an area of the body such as the hip. For this reason, most ridge augmentations are performed using donor bone so that there are fewer incisions and an easier recovery. The result is actually superior in most cases to using the patients own bone.
A cone beam CT scan provides Dr. Singer with a 3D image of the bone so that he can determine the amount of graft required to rebuild the ridge.
Bone Morphogenic Protein (BMP-2)
BMP-2 is an FDA approved protein manufactured by the biotech firm Medtronic. It has the ability to help regenerate bone tissue and is a natural growth factor that helps attract stem cells to an area. It helps patients avoid bone loss after tooth removal. For ridge augmentation, however, BMP-2 alone is usually insufficient to recreate the proper height and width of the jaw. BMP-2 may be used, however, to reduce the amount of bone graft material required for the procedure.
Recovering from Ridge Augmentation
Recovery time varies from patient to patient depending upon the extent of the ridge augmentation. We will provide you with medication for pain and to prevent infection, and we will also give you temporary dietary restrictions. Soft foods that are not spicy will be most comfortable for a short time.
You can expect some swelling and bleeding after the surgery for a short period of time, and you will need to clean your mouth very carefully. We will give you full instructions so that you can avoid pain and infection.