Reconstructive Surgery When Tooth Loss Has Occurred
When natural teeth are lost – either as a result of injury, advanced periodontal disease or other medical or lifestyle conditions – the impact to the surrounding bone and tissue will be progressively detrimental to the patient’s oral health. If left untreated, it often becomes impossible for the patient to restore their teeth through dental implant placement when the bone and/or tissue has been compromised.
The Pennsylvania Center for Dental Implants and Periodontics has treated thousands of patients with highly advanced procedures that can help restore the area where tooth loss has occurred and prepare the patient for a successful dental implant procedure. Dr. Levine has been involved in clinical research and publication on bone reconstructive procedures.
Bone Grafting (Ridge Reconstructive Surgery/Ridge Preservation)
When tooth loss has already occurred, the associated jawbone will often sink in and shrink over a period of time. This often creates a condition where the poor quality and quantity of bone makes the patient ineligible for the placement of dental implants.
However, we now have the ability to grow bone where needed and prevent future bone loss as well, using advanced biomedical materials such as GEM-21 ®mixed with bone grafting material with Titanium mesh and PRGF (Plasma Rich in Growth Factors). This gives us the opportunity to place implants of proper length and width, and it also gives us a chance to more effectively restore esthetic appearance and functionality.
Hard Tissue Reconstruction/Ridge Augmentation (to correct gum indentation)
The loss of one or more teeth can cause an indentation (concavity) in your gums and your jaw bone. Frequently, this looks unnatural and detracts from the appearance of your smile. It can also preclude the ability to place a dental implant due to lack of bone. Dr. Levine has a long, successful history in using a procedure called Ridge Augmentation to recapture the natural contour of your gums and jaw. This gives you the appearance of a new tooth that is natural-looking, easy to clean and beautiful, giving you a brilliant and symmetrical smile.
Crown Lengthening (Pre-Prosthetic Surgery)
When a tooth is broken near or below the gum line, it cannot support a crown or other prosthetic materials. Rather than pulling the tooth and having to replace it with a dental implant, we can frequently salvage it using a Crown Lengthening technique.
Crown Lengthening is a surgical procedure that can create more tooth structure by removing soft tissue (gum) and hard tissue (bone) from the patient’s adjacent teeth (one tooth in front and one tooth behind the damaged tooth). This then becomes a three-tooth procedure, and its goal is providing adequate tooth structure to anchor the new crown.
If the tooth cannot be saved, other options — such as a dental implant — will then be discussed. An option in certain situations of single-rooted teeth is orthodontic extrusion of the tooth.
Sinus Augmentation (or Sinus Lift) to support Successful Implant Placement in the Upper Back Jaw
The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality (the upper jaw naturally has less bone density than the lower jaw) and the close proximity to the sinus. Sinus Augmentation (also called Sinus Lift Surgery) can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material mixed with your own PRGF (Plasma Rich in Growth Factors).
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 9 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented when there is adequate available bone to begin with. This procedure is called a site-specific sinus lift (osteotome) and reduces the healing time significantly.
Undergoing sinus lift surgery has been shown to greatly increase your chances for successful implants that can last for years to come. Most patients experience minimal discomfort during this procedure as well as after.
Related Articles from our Patient Education Center:
- Levine, Robert A., Katz, D.G. Forced Eruption in the Esthetic Zone as an Option to Implants in the High Lip Line Patient: A Case Report, Inside Dentistry, November/December 2006.
- Present, S., Levine, R.A. “Single Maxillary Anterior Tooth Restoration,” Inside Dentistry. 2010.
- Levine, R.A. “Bilateral SFE with Transcrestal and Lateral Window Technique Using Various Composite Grafts,” ITI Treatment Guide. 2011.
- Levine, R.A. Chapter in Text Book “Implant Site Development”: “Horizontal Ridge Augmentation Using Particulate Allograft and the Principles of GBR,” Wiley-Blackwell Publishing. 2011.
- Levine, R.A. “GBR in the Esthetic Zone: Site Development for Prosthetically Driven Implant Placement,” Exactech, Inc. 2006.
- Levine, R.A., Horowitz, R. “Bone Reconstructive Surgery for Implant Site Preparation,” Functional Esthetics & Restorative Dentistry Series 1(2): 20-28. 2007.
- Levine, R.A., Martin, W. “Esthetic Risk Assessment in Implant Dentistry,” Inside Dentistry. 2012
- Levine, R.A., Nack, G. “Team Treatment Planning for the Replacement of Esthetic Zone Teeth with Dental Implants”, Compendium of Continuing Education in Dentistry. 2011.