I need new dentures – can bone grafting and maxillofacial surgery help me?
Posted on 29 July 2017
Loss of teeth may cause loss of bone in the jaw. This means that there may not be enough bone for implants, or your dentures may not fit well. In this case, bone grafting surgery performed by a maxillofacial surgeon may help you. A Mediclinic expert explains how this tried and tested surgical technique can help someone to smile confidently, eat without difficulty and talk properly again.
‘Placing some bone and implants in the lower jaw of an elderly patient to secure their lower dentures is one of the most satisfying things you can do in dentistry. It makes a major change in a patient’s life,’ says Dr Andries Dreyer, a maxillofacial and oral surgeon at Mediclinic Tzaneen. He adds that what many people don’t know is that expert help to perform this surgical technique is available.
‘Bone grafting is a surgical procedure that replaces missing bone and has been used in different types of surgery for a long time and has a history of development. Orthopaedic surgeons were the first to do bone grafts in other parts of the body and developed many of the basic principles which we use today,’ says Dr Dreyer.
Before implants were available, complicated pre-prosthetic surgery and unreliable bone grafting techniques were used to help people use dentures. ‘Once we started using implants regularly, we could radically develop more reliable techniques,’ explains Dr Dreyer.
‘Unfortunately, many patients do not have optimal bone conditions for placement of implants, and we needed some way of augmenting the ridge of the jaw,’ he adds.
The exact surgical technique is individualised for each patient and may differ between different surgeons but some general principles apply. For example:
‘In certain situations, we do immediate bone grafting,’ says Dr Dreyer. ‘In this case, we remove the damaged tooth or teeth, clean out the sockets and fill them with bone, sometimes from the patient or from a bone bank or artificial bone substitute’.
The donor bone from bone banks is easily available and medically prepared to be safe for all patients, while artificial bone can be costly. If the bone is harvested from the patient, it is usually taken from their jaw or hip.
‘We use the bone to build up the ridge, cover it with a membrane and allow about six months for the body to ‘accept’ the bone,’ he says. What this really means is that the body removes the foreign bone and replaces it with the patient’s own bone. They hope enough new bone remains to create a ridge into which implants can be placed to support a denture or crowns.
However, the bone doesn’t always ‘take’, especially if people have uncontrolled diabetes, metabolic bone disease or smoke regularly.
In addition to the maxillofacial and oral surgeon, the team that ensures the successful transition to crowns or dentures includes a periodontist (who also improves the gums and soft tissue and a prosthodontist (who places the crowns or dentures on top of the implants and new ridge). Referrals can be requested at your dentist.
‘If everything is done correctly, there isn’t any complication afterwards and the patient practises meticulous oral hygiene, you should have good long term results with little bone loss’.
Dr Dreyer recommends that patients look for an experienced surgical team for superior results.