Pre-implant surgery, osseodistraction, bone grafting Flashcards
Why do pre-implant surgery? (2)
To little bone to support implant in an acceptable position
Too much bone(!) – ridge reduction
Ridge reduction undertaken for (2)
- bone of poor quality (width)
- additional restorative space
Augmentation (3)
Lots of confusion between types of augmentation versus techniques
Techniques include Sinus lift, block graft, GBR, ridge split, zygomatics, use of narrow/short implants, etc.
Types of augmentation is different!
Types of augmentation (4)
Autograft – pinch a bit of bone from somewhere else on the same patient
Allograft – get some bone from someone else (not necessarily dead!)
Xenograft – get some bone from an animal
Inorganic Material – Beta TCP and HAP
Issues with osseoinductive and osseoconductive methods (2)
Inductive - promotes bone formation
Conductive - scaffold
Techniques for width (4)
- GBR
- Ridge Split
- Block Graft
- arrow/angled implants
Techniques for height (5)
- Onlay graft (still a block graft)
- Inlay Graft
- Osseodistraction
- Short implants/ all-on-4
- Zygomatic implants
Clinical scenarios: inadequate bone width (3)
- small amount
- moderate amount
- large amount
Clinical scenarios: inadequate bone height (4)
- overall
- in relation to adjacent teeth
- in relation to anatomical structures
- anatomical site also influences choice
Aim of dual layer technique (4)
Bone Chips- osseoinductive
Bone substitute- e.g. Creos/ Bio-oss – osseoconductive
Absorption of bone-conditioned blood makes bone substitute osseoinductive
Membrane over top to prevent soft tissues contacting and resorbing grafted material
Complications with mandibular symphysis grafts (4)
Reduced sensitivity over the chin
Scaring in buccal sulcus – fraenal tags
Chin ptosis
Damage to the incisor/ canine roots
