By Karl-Erik Kahnberg
This booklet explores the potential for bone grafting ideas to rehabilitate the maxilla during the placement of dental implants. As implant dentistry turns into more and more good validated and complex, this ebook may also help skilled surgeons to contain implant ideas as a part of more difficult reconstructions within the top jaw.Starting with a recap on ideas of bone biology, the booklet then considers implant integration in general bone and with bone grafts. Grafting strategies are provided depicting a number of bone harvest websites, by means of onlay and inlay grafting concepts. methods to sinus lifting, segmental osteotomy and distraction osteogenesis for augmentation protocols are supplied.
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Extra resources for Bone Grafting Techniques for Maxillary Implants
Healing takes 6–7 months. Abutment connection is carried out according to the standard protocol. 19 One-stage grafting. 20 Clinical view of posterior maxilla with elevation of mucoperiosteal ﬂap and osteotomy performed according to the window technique using a round bur. 21 Elevation of the sinus membrane and infracture of the bony window. 22 The sinus recess is created for the bone graft by lifting the bone window and sinus mucosa. 23 Bone graft from iliac crest (cortical and cancellous) is positioned in the sinus recess and implants inserted.
22 Light compression of the soft tissue by the acrylic stent connected to the zygoma. 23 Acrylic wafer with posterior extension to avoid trauma to the grafted region. 24 The onlay bone graft is connected to the alveolar crest by simultaneous insertion of the implant screws. 25 Careful attention is taken to remove all sharp edges of the graft. 26 The incision is closed with continuous suturing. 27 Soft tissue healing after ten days. 28 Implants in place in the upper jaw. 29 Radiograph of bone graft and implants.
6 Fixture exposure after anchorage in the marginal area and the nasal bone. 7 Exposed threads covered with bone graft from BoneTrapTM. 8 Thin bone lamellae now covering the ﬁxture after four to ﬁve months healing. Minor bone graft in block form In the majority of cases, onlay block grafts of cortical bone are indicated where there is a need to improve the width of the thin alveolar process or to increase the height in localized defects. Minor onlay grafts used to increase width are often placed buccally on the crest (buccal onlays) and secured with titanium plate screws.