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Guided Bone Augmentation

The bone may be lacking height, width or a combination of both (vertical and horizontal).

When bone thickness (width) is lacking, the problem can be solved by splitting and packing the existing bone while creating a space where the implant will be inserted.

Bone is not high enough or a combined issue

*An additional method is the addition of a block of bone (autograft/artificial) which serves as a temporary support. The bone will grow into it and around it, and will replace it. After a few months, the implants can be inserted.

Guided Bone Regeneration

Sometimes, when bone absorption significantly reduces the size of the jawbones, there is an option of rebuilding the bone using a technique of implanting bone or its substitute. Bone implants can build or fill in flaws in the bone, and thus enable the placement of dental implants. This technique represents one of the best advancements in modern dentistry. This process is called GBR – guided bone regeneration; reconstruction of the gums alone is called GTR – guided tissue regeneration.
In general, there are 4 types of bone implants:

1. Autograft (Self-source)
This is a bone graft in which the bone which the doctor will implant is a bone that was taken from a different area in the individual’s own body. Usually, the donating area is a different area of the jaw. Since the bone is from the person’s own body, the match between the donating area and the receiving area is very good, as well as the match between the donation and all of the other tissues surrounding the receiving area. This type of implant was considered to be the best option until a few years ago, providing the best results.

2. Allograft (Human Source)
This bone implant comes from human bone but not from the individual’s own body. In most enlightened countries, there are programs for organ donation through which a person authorizes that if he dies, various parts of his body could be donated to people who need them. Heart, liver, cornea and other transplants are all types of allograft. Bone that comes from a human donor undergoes strict examinations and complete sterilization. The body receiving the donation is able to turn this type of bone into its own bone material, so that after the implant, the body will replace the “foreign” bone with its own bone.

3. Xenograft (Living Source)
This bone implant originates from an animal source, usually bovine. The bone undergoes specific processes which render it sterile and compatible with the human body (biocompatibility). After this bone is inside the body, it also undergoes a process of replacement with human bone and in fact constitutes the frame upon which the individual’s own bone will grow. Today, with moderate lack of bone, this is considered the best alternative.

4. Non-living source – Coral
There is no risk of infection, since the tissue is not from a living source. This substitute has proven successful in clinical studies.

5. Alloplast (Synthetic Source)

This implant is not bone, but rather an inert, synthetic artificial material created in laboratories. An example of this type of material is the implantation of an artificial joint made of platinum or titanium alloy. When we are interested in building bone, we will try to use materials that imitate bone, materials that usually will include calcium and phosphorus. Dependent on the way the material is created and the type, the bone substitute will be either “absorbed” or “not absorbed” – in other words, our body may replace the material with its own bone material, or it will not replace the material, dependent on the type of material. In any case, the final objective is building enough bone to enable to placement of dental implants.

The type of bone implant is usually chosen by the dentist according to the surgical and rehabilitation requirements of the patient. The primary problem is that the amount of the individual’s own bone material is very limited and absorbed too fast. Therefore, when a small amount of bone is lacking, it is customary to use a small amount of bone from the area of the surgery, and to mix with bone type 2 or 3. The greater the area where bone is lacking, the greater the amount of bone type 2 or 3 is used. Bone type 5 is the lowest quality and the cheapest, and its use is limited.

The modern bone implantation techniques are nothing less of a miracle for people who require dental implants, enabling the placement of dental implants, and later, the construction of crowns which look like teeth and enable functional mastication and return to full activity, very similar to that of people with natural teeth.

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