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Bone grafting yes or no

A dental implant is a screw with a diameter and a length. Do not forget that the purpose of an implant is to support a dental prosthesis and if it is too small or too thin, its resistance to masticatory forces will be less. It is therefore common to use implants having at least 8 mm in length and 3.5 mm in diameter. This requires that the bone in which we will ask our implant has at least the length of the implant chosen and a width greater so that it is completely surrounded by bone.This is why we define the lack of bone in both width and height.

Lack of bone height

Le problème du manque d'os en hauteur se pose différemment à la mandibule (machoire inférieure) et au maxillaire (machoire supérieure).The problem of insufficient bone height arises differently in the mandible (lower jaw) and maxilla (upper jaw).


1-In the mandible
Sur la partie antérieure de la mandibule, qui est la zone du menton, l'os se trouve toujours en quantité suffisante pour permettre la pose d'un implant dentaire.On the anterior part of the mandible, which is the area of ​​the chin, the bone is always sufficient to allow the placement of a dental implant. At the rear, the lack of bone height is a more difficult problem, its resolution will involve more skill and experience of the practitioner who will speak, and claim the use of bone from the patient itself. Bone graft will only be achieved if the smaller implants may be used or the chin area does not allow itself to find a solution to the problem of the implant patient.2-In the maxilla.

Bone grafts in height are easier to perform by virtue of the quality of the bone at this level (more spongy bone of the mandible). On the front, if there is lack of bone height, it can provide. against by the posterior, we can solve the problem by grafting the sinus. This bone graft a portion of the sine called " sinus lift "is to fill the lower part of the sine to increase bone height.
It is useful when we have only a few millimeters of bone under the sinus and is the implant while simultaneously lifting the sinus. It entwines less postoperative but is limited in its indications.

Lack of bone width

Cette situation est plus facile à résoudre. This is easier to solve. Si il ne manque que très peu de largeur, il est possible d'élargir légèrement la crête osseuse en posant l'implant. If it lacks very little in width, it is possible to slightly widen the bone crest by placing the implant. Si le manque est un peu plus important, on utilse des biomatériaux (voir chapitre suivant) pour apporter de l'os et réaliser ainsi la greffe osseuse sans avoir besoin d'utiliser l'os du patient. If lack is a little more important, we used some biomaterialsto bring the bone and make bone graft and without the need to use the patient's bone. Pour un manque plus important et plus étendu, la résolution du problème passera par une "autogreffe", c'est-à-dire que l'on va prélever de l'os sur un " site donneur " du patient lui-même afin de le greffer sur la zone à implanter. For a lack larger and more extensive, solving the problem will require an"autograft", that is to say that we will take the bones to a "donor site" the patient himself to graft it onto the area to be implanted. Schéma d'une greffe en largeur

L'axe de l'implant dentaire The axis of the dental implant

The problem of the axis of the implant is extremely important. It can sometimes be enough bone to implement, but following the crestal bone, the dental implant can emerge in a place that makes it difficult to use or for which the esthetic is not satisfactory.To solve this problem, we realized a small bone graft that allows the implant axis in a more usable at all levels.

 

greffe osseuse 1

greffe osseuse 2