Bone/Gum Grafting & Sinus Lift

Bone Grafting

The implant needs to be surrounding by a good volume of stable bone. Where there isn’t enough bone, bone grafting would need to be considered.

This is a common problem in certain areas of the mouth, and especially if the teeth have been removed some time ago.

There are typically 4 types of bone grafting materials:

  • Patient’s own bone (which is the best bone)
  • Donated human bone
  • Animal bone (usually cow/pig/horse)
  • Synthetic bone substitute

In simple cases, the implant will be placed and additional bone grafting material is used around it,to ensure the full circumference of the implant is covered in bone. In more complex cases, or larger bone defects, a separate procedure may need to be undertaken, where bone is taken from back of jaw or chin and transferred into the defected area.Recent developments in 3D technology have allowed us to use CT scans to order patient specific bone graft blocks, or a 3D printed titanium mesh to help with these larger grafting cases.

Gum Grafting

Where the gum tissue around a tooth or implant is very thin, we should consider gum grafting to increase the thickness to create a thick, healthy and firm gum profile.

By increasing the thickness of the gum, we are able to reduce the likelihood of recession (where the gum shrinks back), and reduce the susceptibility to the plaque bacteria, which would lead to gum disease.

This procedure should therefore be considered when planning for dental implants.

A gum graft is essentially a plastic surgery procedure of the gum, it involves taking a piece of the thick connective tissue from roof of mouth and transferring to where it is needed (next to the implant, for example). Once this has healed, this will give a stable and thick cuff of gum from which the implant or tooth emerges.

Sinus Lift

The sinus is an air space in the upper jaw, which can expand, especially if the tooth has been missing for a period of time.

When planning for implants in the upper molar and premolar region, we may find the sinus is in close proximity to where the implants need to be. Therefore, a sinus lift procedure would help to move the sinus away, increasing the height of the bone available for the placement of the dental implant. 

Often, a bone grafting material would be used to help to achieve this.

This is usually undertaken by creating a small opening to enter the sinus from the side and gently lifting membrane away to create the space. The bone graft material is then inserted into the sinus cavity and, if the conditions are suitable, the implant can often be placed at the same time.

Healing for this procedure would be approximately 6 months, after which the crown can be attached.

Platelet Rich Fibrin (PRF)

This is a form of PRP and involves taking blood from the patient, in a similar way to having a blood test, then placing the test tubes of blood in a centrifuge. 

At the end of the spin we will obtain a fibrin clot, containing a high volume of the platelets and white blood cells.

This fibrin clot is called Platelet Rich Fibrin or PRF. This will gradually release growth factors into the site. The objective of these growth factors is to accelerate the soft tissue and bone healing.

It can be used in implant treatments, especially when teeth are removed, during bone grafting and when performing sinus lifts.

Partial Extraction Therapy (PET) / Socket Shield

Partial Extraction Therapy, or socket shield treatment, is where a small portion of the root of a failing tooth is intentionally left in place in order to improve the aesthetics of the implant treatment.

The gum and bone usually shrink back when the tooth is removed, therefore in some situations the outer part of a root may be carefully cut away and left in place, while the rest of the tooth (along with any infected parts) are removed. The thin section that remains, will ensure the blood supply continues to the bone and gum, resulting in a stable gum profile and a very nice looking result.