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Chin bone graft

In some particular cases, you have not enough bone for implant placement because of tooth loss from periodontal (gum) disease, injury or trauma, or a developmental defect. If your jaw is too short (up and down), too narrow (side to side), or both, you will need a procedure to add bone to your jaw before implant placement. There are several different procedures that can be used for bone augmentation. Your dentist will select a procedure depending on the type, location and number of implants to be used. However, in some particular cases, chin bone graft procedure is the best method to make sure implant procedure be successful.

CLINICAL CASE

Surgeon: DDS, MDS. Vo Van Nhan

Patient: a 30 years old man patient, healthy was in good and non-smoker. The missing teeth on upper jaw had been absent for 10 years therefore 
the bone resorption became serious. After a consultation on treatment options, the patient requested an implant-retained fix restorative solution.

chin bone graft chin bone graft
  You can observe the bone resorption on anterior teeth. Occlusal view of the  edentulous space revealing a horizontal hard tissue deficiency

To have a detail treament plan, we took some x rays to decide the volume bone which we needed to take from chin bone and both the type of dental implant and how many dental implant was used. This was one of the most important steps to have successful procedure.

After the analysis, the overall esthetic risk for this treatment was low. There was no infection at implant site and some another advantageous factors. This low esthetic risk indicated that potential for an esthetic result based upon the ITI Consensus Statements for an implant restoration was high.

Two phrases of treatment was planned:

- Augmentation and implant placement at the same time.

- Restoration with all ceramic bridge on the implants

TREATMENT PROCEDURE

Augmentation and Implant placement

Autographs and allographs were considered. Due to the patient's jaw bone condition, chin bone graft was indicated.

chin bone graft chin bone graft
Two block grafts were harvested from the chin to be used for onlay graft at anterior teeth

We then made an incision in the gum below the lower front teeth to expose the chin bone. Two blocks of bone were removed from the chin along with any bone marrow. After that we filled the spot where the bone was removed with another type of bone-graft material, and  covered this with a membrane (thin film of tissue) to keep soft tissue from filling the space as it heals. The incision then was stitched closed.

chin bone graft chin bone graft
 The spot was filled with another type of bone-graft material   The spot was covered this with a resorbablemembrane

chin bone graft chin bone graft
 Elevation of the tissue and removal of any soft-tissue residue on the surface of the bone  Implant placement

To place the removed bone in the recipient site, we the first drilled little holes in the existing bone to cause bleeding. This was done because blood provides cells that helped the bone heal. The block of bone that was removed from the chin was anchored in place with titanium screws. A mixture of the patient's bone marrow and some other bone-graft material  then was placed around the edges of bone block. Finally, the dentist placed a membrane over the area and stitched the incision closed.
 chin bone graft
 
chin bone graft
 We drilled little holes in the existing bone to cause bleeding  Some other bone-graft material  then was placed around the edges of bone block

chin bone graft chin bone graft
 A membrane was placed over the area  The incision was stitched closed
After a bone-augmentation procedure, you were given antibiotics, pain medication and an antibacterial mouthwash. You were asked to avoid certain foods, and were told how to avoid putting pressure on the area while it heals. If you wear a denture, you MAY NOT be able to wear it for a month or longer while the area heals. If you have natural teeth near the bone graft, we may make a temporary removable bridge or denture to help protect the area.

RESTORATION

The bone block graft took about 6 to 12 months to heal. At that time, the titanium screws used to anchor the bone block in place were removed
before restoration was placed.

chin bone graft chin bone graft
 The block grafts integrated well after 6 moths The titanium screws were removed
After removal of
the titanium screws, the healing cap were palced and the tissue was colsed with a suture. The patient was scheduled for a follow up appointment after two weeks.

chin bone graft chin bone graft
The healing cap were palced the tissue was colsed with a suture

After two weeks, restoration with all ceramic bridge had been placed after the all ceramic frame were tried. At that time, we took an x ray to check whether the frame were correct.

chin bone graft chin bone graft
The all ceramic frame All ceramic restoration

chin bone graft chin bone graft
The final restoration
chin bone graft chin bone graft
Before After


Nhan Tam Dental Clinic – Dental Implant And Cosmetic Restoration
Address: 807, 3/2 Street, Ward 7, Dist. 10, Ho Chi Minh City, Viet Nam - Tell: (+ 84) 8 3957 0229 –  (+84) 8 3957 5569 . Mobile (+84) 903.632701 (+84) 938.344970 
Website: www.nhakhoanhantam.com - www.implantvietnam.info - Email: drnhan@hotmail.com – drnhan1@gmail.com - Copyright © 2008 by Nhan Tam Dental Clinic