What is Alveolar Ridge Augmentation?

Alveolar Ridge Augmentation

Bone resorption following tooth loss often interferes with dental implant placement in a desired position, and requires additional bone augmentation procedures. Many techniques have been described to augment and reconstruct alveolar ridge width and height.

The alveolar ridge augmentation procedure works by increasing the amount of gum and bone tissue in areas that have experienced loss, and can also be effective for surface preparation of a dental implant.

What is an alveolar ridge?

The alveolar ridge is the upper portion of the jaw bone. Its purpose is to securely fix the teeth in the jaw. The alveolar ridge is an extension of the maxilla (the upper part of the jaw) and the mandible (the lower part of the jaw) and is a bony ridge that holds the sockets of the teeth.

The alveolar ridge is a important anatomical structure for healthy teeth and successful dental implants after teeth loss. When a tooth is lost from the upper alveolar ridge or the lower mandibular alveolar ridge, bone loss typically occurs. According to the studies conducted on patients of tooth loss, this bone loss, or alveolar ridge resorption, can be as much as 30-60% of bone.

The diagnosis of the height of the alveolar ridge is given special attention in preparation for prosthetics and implantation. Bone preservation of the ridge plays an essential role in ensuring proper healing of the gum tissue if you want to replace the lost tooth with an implant.

What happens to alveolar ridge after tooth extraction

If the extraction of a tooth was carried out long before implantation and at the same time certain measures for prosthetics were not carried out, the bone tissue in this place, devoid of functionality, gradually atrophies (dissolves).

As a result, the thickness of the alveolar bone ridge becomes less than the diameter of the implant. In such a situation, implantation is impossible without preliminary enlargement of the alveolar ridge to a size in which a gap of at least 3 mm remains between the implant and the edge of the bone on each side.

Alveolar ridge augmentation methods and materials

Alveolar ridge augmentation is a very effective procedure for restoring the natural contours of the gum and bone. Bone augmentation can be done in different ways. The bone used can be taken from elsewhere in the same person's mouth.

Ridge augmentation is possible by using human bone from another site of the body or of animal origin, provided by bone banks. It goes without saying that these products have been processed, sterilized and tested to be safe.

There are also various synthetic substitutes for these materials: growth factors and proteins that increase bone formation. In general, membranes are used to cover these materials.

The choice of materials and technique used will depend on your particular situation and the analysis of your periodontist.

Soft tissue augmentation

Soft tissue augmentation is usually performed to improve the aesthetics of the treated area and involves making a small incision to expose the location and performance of a soft tissue graft.

Reconstruction of the natural contours of the gums is often recommended for aesthetic and not medical reasons. A big hollow in the gums can trap bacteria and food, which can cause oral health problems throughout your life.

The alveolar ridge augmentation procedure works by increasing the amount of gum tissue in areas that have experienced loss, and can also be effective for surface preparation of a dental implant.

Hard tissue augmentation

Hard tissue augmentation is performed to recreate bony contours before dental implants or other tooth replacement procedures are placed. If you've had some degree of bone loss, this procedure involves lifting some of the gum tissue to expose the bone, then placing the graft material around the areas with bone loss.

In both procedures, the area is closed with stitches to ensure optimal healing. The healing process usually takes four to six months.

Ridge augmentation through autotransplantation

How is the alveolar ridge augmentation carried out?
The optimal way to simultaneously increase the width and height of the ridge is bone autotransplantation, that is, the transplantation of a donor material taken from the patient himself.

Bone tissue is transplanted in a solid block, which can be removed from the chin zone, the retromolar area (at the end of the dentition, behind the “eights” teeth), the tubercle of the upper jaw and other areas.

The technique of bone grafting takes place in several stages.

Full engraftment of the graft will take about 4-5 months. After this period, you can start implantation, as well as to remove the fixing screws.

Before the operation, it is advisable to visit a dentist-therapist who will carry out professional cleaning of teeth with the removal of plaque and calculus.

Ridge Augmentation through Piezo Surgical Instrumentation

One of the most predictable methods, which is also characterized by the least possible complications, is the splitting of the alveolar ridge using piezo surgical instrumentation.

When carrying out this technique of increasing the volume of the alveolar ridge, the patient's own bone tissue is maximally used, and the implant is installed in conditions when it is completely surrounded on all sides by its own bone. This allows you to get a full osseointegration of implants and reduce the treatment time before the start of the orthopedic stage.

When performing the operation of splitting the ridge with piezo surgical instruments, the risks of damage to the surrounding tissues are reduced compared to the use of rotating instruments.

Also, the patient experiences less discomfort due to the absence of vibration. For the doctor, control is significantly improved during the cuts of the alveolar ridge and the risks of intra- and postoperative complications are reduced.

How to behave after surgery: general recommendations

It is worth remembering that slight bleeding in the first few hours after surgery is normal and not a cause for panic. If you are taking aspirin or other anticoagulant drugs, the bleeding may last longer. In this case, it is recommended to press the bleeding area with your finger or rinse the mouth with cold water.

Sleep on a high pillow in order to increase the outflow of blood from the area that was operated on. And only if the bleeding does not stop for more than a day, you should consult your doctor.

In addition, it is important:

Surgeries to enlarge the alveolar ridge are not performed in every dental clinic. Many dentists suggest that their patients go to an inpatient maxillofacial surgery unit and then return for implantation.


References

Den Tim


Practicing Dentistry for 20 years