Чи небезпечне нарощування кісткової тканини у стоматології?

What are the dangers of bone augmentation – this is the question that interests many patients of dental centers who are planning to implant teeth. The presence of atrophied tissue in the upper or lower jaw does not allow such a procedure to be performed immediately. Initially, it is necessary to prepare the site for implant placement. The process is long and involves a number of difficulties, which make patients think about the feasibility of such a procedure.

Let us now consider in more detail the causes of bone thinning. We will cite the clinical conditions, where it is indicated to carry out an augmentation stage. Consider the main varieties of bone grafting and the compositions used. We will describe the potential risks and dangers for patients who face the need for bone augmentation on the lower or upper jaw. The presented information will allow you to orient in detail in the peculiarities of the procedure and determine the possibility of its implementation.

Why does jaw bone tissue thin out?

Modern dentistry is often faced with such conditions, where there is a significant thinning of the jawbone, its height and volume become smaller. At the same time, the roots of the teeth may be exposed, which has a negative impact not only on aesthetics, but also on functionality. This pathology can develop as a result of bacterial infections, traumatic conditions, congenital anomalies, changes that occur with age, including a decrease in the intensity of blood supply to the jaws, the presence of neoplasms and cysts, a number of gum diseases, prolonged use of dentures.

But the most common cause of thinning is tooth extraction. The absence of one or more teeth will be enough for the bone in the area of the lost tooth to gradually atrophy. This occurs due to the lack of a stable chewing load on the jaw. Previously, as long as the tooth was in place, the blood vessels had to respond to this pressure by supplying the nutrients necessary for the tissue to function properly.

In order to minimize the consequences of bone atrophy, bone grafting is performed to allow for dental implantation. This is the only way to restore the bone’s ability to bear the necessary load and create all the conditions required for a full-fledged restoration of the tooth.

Jaw augmentation is indicated for patients with the following clinical conditions:

• еxcessive thinning that prevents dental implants from being performed;
• jaw trauma;
• bone resorption with age;
• deformity of the facial oval.

In order to eliminate these manifestations, to provide the necessary bone grafting during implantation, the augmentation stage is performed.

Bone augmentation for implantation: main varieties

Modern dentistry uses 4 technologies for bone augmentation. They differ in the steps involved and the materials used:

1. Directed regeneration. It is indicated in cases of mild to moderate jaw tissue atrophy. Its volume is increased by stimulating self-expansion. During the procedure, the doctor introduces new bone tissue point by point, fixing it using a self-absorbing membrane. This solution additionally provides an anti-infective protection. In this way, the natural regeneration stage is triggered.
2. Splitting of the alveolar ridge. This is the element of jaw tissue that holds the tooth row together. In this case, the ridge is sawn and artificially expanded. The resulting cavity is filled with bone substitute.
3. Sinus lifting. This procedure is performed exclusively on the upper jaw in the area of the nasolabial fold. Here, a bone substitute is used to fill part of the maxillary sinuses.
4. Addition of new bone blocks. It is performed in cases where there is a serious lack of jaw tissue. Bone grafting in implantation can be performed using the patient’s own tissue (autotransplantation). It can be taken from the chin, upper jaw, or femur. Synthetic or donor tissues from humans or animals can also be used. The option of autotransplantation is more preferable, as the engraftment of the bone block or used chips is guaranteed. 

Which augmentation method will be used during the surgery depends directly on the current state of the patient’s bone tissue. A thorough examination is performed and based on the total clinical picture, the best option for each patient is selected. The augmentation process itself can be performed vertically, if it is necessary to restore the height of the jawbone, or horizontally, if the task is to expand it.

Materials used in the treatment of bone atrophy

The bone tissue of a tooth can be restored using different groups of materials:

1. Autogenous. This involves using the patient’s own bone material, as we discussed above.
2. Allergenic. Donor tissue from another person is used.
3. Xenogenic. These are also donor materials, but made from animal bone.
4. Alloplastic. Bone materials of artificial origin.

Bone augmentation: the main dangers

Modern dentistry is constantly improving the technology of bone augmentation for implantation. The approaches and consumables used are changing. All this is designed to accelerate the stage of bone tissue restoration, improve engraftment, reduce discomfort for a person, get a long-lasting and durable result. But there are still a number of dangers that can be encountered:

• Risk of rejection. This phenomenon is relevant for cases when bone augmentation is performed using artificial osteoplastic material. Here it is possible to develop allergic reactions, individual intolerance of the body. Once again, we note that autotransplantation increases the likelihood of total engraftment after surgery.
• Low build-up efficiency. It manifests itself in situations where the patient is diagnosed with pathologies of the circulatory system. In this case, the body can not provide full nutrition of bone tissues. There may be resorption of the material, which will cause the need to replant it again.
• Age-related changes in the body. Already after 35-40 years of age, regenerative processes in the body slow down considerably. This reduces the effectiveness of jawbone volume increase using the surgical method.

Contraindications to bone grafting

Such surgical intervention as bone grafting is contraindicated in the following categories of patients:

• type 1 diabetes mellitus diagnosed;
• maxillary sinusitis, sinusitis, infectious diseases in the acute phase;
• pathology of blood-forming organs, coagulation disorders;
• presence of tumors of different etiologies in the dento-mandibular region;
• psychiatric diseases in the period of exacerbation;
• intolerance to drugs used in anesthesia.

To determine the possibility of bone augmentation on the lower and upper jaw, doctors perform a comprehensive diagnosis of the patient, which includes clinical urine analysis, blood sugar, infections, determination of blood coagulation by coagulogram.

How to minimize the negative effects once the bone augmentation is completed?

The whole process of human recovery after bone augmentation takes about 3-6 months. In order to heal as quickly as possible and without complications, it is necessary to follow the doctor’s recommendations:

1. Reduced physical activity, and ideally absolute suspension of sports until the surgical stitches have completely healed.
2. Compliance with diet after surgery. It is recommended to remove from the diet hot and too cold food, solid foods. Salty, spicy, strongly seasoned food can also irritate the mucosa, causing inflammatory reactions.
3. Minimize pressure on the operated area. If possible, chew food on the other side. The optimal solution is to eat broken food in the form of mashed potatoes.

High-quality modern dentistry, which is offered by the Medical Center “Prizma”, is able to minimize the negative consequences of bone augmentation and provide easy recovery with minimal discomfort for the patient. This is facilitated by thorough preoperative preparation, advanced techniques, technologies and materials, high practical skill of doctors.