Procedure to add bone tissue to preserve the alveolar ridge after extraction or to increase insufficient bone volume before implant placement.
Indication
- Need for alveolar ridge preservation after tooth extraction
- Insufficient bone volume (width or height) before implant placement
- Alveolar bone defects related to periodontitis
- Intrabony (infrabony) pocket and furcation defects
- Bone cavities resulting from cyst or tumor removal
- Alveolar bone loss caused by trauma
Preparation
- Clinical examination and assessment of bone volume with panoramic imaging or CBCT (cone-beam computed tomography)
- Evaluation of systemic conditions and smoking status
- Planning of any anticoagulant medications with the relevant physician
- Selection of the graft type (autogenous, allograft, xenograft, synthetic) based on the patient
- Optimization of oral hygiene before the procedure
How it's performed
- Local anesthesia is applied to the procedure site
- The gum is reflected to access the alveolar bone
- The defective area is cleaned and the appropriate graft material is placed (autogenous, allograft, xenograft or synthetic)
- When needed, a resorbable or non-resorbable barrier membrane is applied (guided bone regeneration)
- The gum is closed without tension and sutured
- The implant can be placed in the same session or 4-9 months later, after the bone matures
Post-procedure
- Cold compress and head elevation in the first 24 hours
- Suture removal after 7-14 days
- Soft and lukewarm food in the first 1-2 weeks
- Smoking cessation (smoking adversely affects healing)
- Follow-up of bone maturation with panoramic imaging or CBCT (3-6 months)
Risks
- Postoperative swelling, pain and bruising
- Graft and membrane exposure
- Infection and graft loss (especially in smokers)
- Complications related to nearby nerve or sinus (upper posterior jaw)
- Less bone gain than expected
FAQ
Which materials are used for the graft?
Options include the patient's own bone (autogenous), human-derived (allograft), animal-derived (xenograft) or synthetic materials.
Can the implant be placed in the same session?
If the bone volume and primary stability are adequate, it can be placed simultaneously. Otherwise, the implant is placed within 4-9 months after the graft matures.
Can the graft be rejected?
The biocompatible materials used are not rejected by the immune system. The main risks are infection and dislodgement of the graft.
How long does it take to heal after the graft?
Soft tissue healing takes 2-4 weeks, while bone maturation may take 3-9 months depending on the type of graft.
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