Advanced Implantology

Sinus Lift & Bone Graft Procedure	Ridge Expansion Procedure
Pterigoid Dental Implants	Zygomatic Dental Implants
Dental Impalnts in Jaw Pathology	Dental Impalnts after Facial Trauma

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Less bone in the jaws can be a difficult situation in placement of implants.

When the jaw bone has severely resorbed, placing routine implants would be a challenge. In such situations, the bone bed needs to be rebuilt with advanced procedures such as bone grafting and sinus lifts. Special techniques such as CT guided surgery, pterygoid and zygoma implants may also be necessary.

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Why does the bone loss happen?

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.

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What is a sinus lift procedure?

A sinus lift is surgery that adds bone to your upper jaw in the area of your molars and premolars. It's sometimes called a sinus augmentation. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose.

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What is ridge expansion

In severe cases, the ridge has been reabsorbed and a bone graft is placed to increase ridge height and/or width. This is a technique used to restore the lost bone dimension when the jaw ridge gets too thin to place conventional implants. In this procedure, the bony ridge of the jaw is literally expanded by mechanical means. Bone graft material can be placed and matured for a few months before placing the implant.

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What are pterigoid dental implants and when are they placed?

Bone resorption in the mandibular or maxillary region after tooth loss depends on various factors; general factors such as the individual’s sex or age, or local factors such as trauma or bone metabolism diseases. These changes in the bone structure must be considered in the diagnosis and planning of dental implant treatment.

Dr Girish Rao and his team at Mukha has extensive experience in the area of Implantology. It is one of the centres with the most expertise at international level in placing special implants such as zygomatic and pterygoid implants. These implants enable us to restore the quality of life that all our patients deserve.

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Zygomatic dental implants

The main characteristic of these implants is that they are inserted into two bones that never suffer resorption -the zygomatic bone, for zygomatic implants, and the pterygoid bone, for pterygoid implants- even when there is severe atrophy of the maxillary bone.

This surgical technique offers three major benefits:

• It is a good alternative to bone graft placement for patient’s suffering considerable maxillary bone resorption.
• It reduces the patient’s treatment time safely, quickly and comfortably.
• It guarantees improved aesthetics for every patient, regardless of the quality of their bone for dental implant placement. However, zygomatic and pterygoid implant placement is sometimes accompanied by the use of normal implants, depending on the quality and quantity of the patient’s bone.
• Zygomatic and pterygoid implants are also special because of their length. They are much longer than conventional implants in order to ensure good bone anchorage. Zygomatic implants are 30 to 55 mm long and pterygoid implants are 15 to 20 mm long.

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Dental Implants after Facial Trauma

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There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to vital structures (such as the eyes, facial nerves or the salivary glands).

Injuries to the Teeth and Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. In addition to facial injuries, oral surgeons are involved in treating injuries of the mouth which often includes re-implanting teeth that have been displaced or knocked out. These types of injuries are treated by splinting (stabilize with wire or dental bonding). If a tooth is completely knocked out, it should be placed in salt water, milk or placed under the tongue until reaching the hospital or office. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of re-implanting the tooth. The treating doctor will gently rinse and debride the tooth with sterile saline before re-implanting. Other dental specialists may be called upon such as an endodontist (root canal specialist), and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.

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Dental Implants in Jaw Pathology

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Cysts and tumours affect the jaw bones quiet often. The treatment of these conditions require extensive surgeries which include removal of the affected teeth and the adjacent alveolar (jaw) bone. The treatment itself leads to not only changes in the shape and form of the jaw and facial structures, but significantly affects functions such as speech, swallowing and chewing food.

Dental implants have revolutionised the rehabilitation of these conditions by restoring normal form and function.

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A patient education video to educate and enhance patient knowledge regarding dental implants. A contribution from Mukha Facial Surgery and Dental Impalnt Center, Bangalore, India.