Address: 801 – 803, 3/2 Street, Ward 7, Dist. 10, HCM City
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.
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| 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.
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| 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.
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| The spot was filled with another type of bone-graft material |
The spot was covered this with a resorbablemembrane |
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| 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.
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| 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 |
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| 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.
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| The block grafts integrated well after 6 moths |
The titanium screws were removed
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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.
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| 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.
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| The all ceramic frame |
All ceramic restoration |
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| The final |
restoration |
(This is the clinical case that was treated by Vo Van Nhan DDS, DMS. Any questions, please contact Dr. Vo Van Nhan. Please do not use or copy our content in all forms)
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: 1900 56 5678 – (+84) 938 344 970 - (+84) 938 967 858
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