Follolwing tooth loss , the jaw bone can shrink as much as 25 % in the first year and as much as 40 -60 % in the next 3 years .
With rapid shrinkage of jaw bone after lost of teeth , some form of bone grafting is required . With bone grafting , the dental implants will have better long term prognosis.
Types bone grafting for dental implants
1. Ramus block Graft
2. Internal sinus lift
3. External sinus lift
4. Guided Bone Regeneration (GBR)
5. Hip Graft
A piece of bone can be harvested from the side of the lower jaw (Ramus).
Advantages
1. Autogenous bone ( own bone ) is the gold standard
2. Low risk of host rejection and high success rate
Disadvantages
Another surgical site required.
A piece of bone harvested from the back of the lower jaw.
The harvested bone is than transfer to the implant site and screwed in place.
New bone will be form in 4 -5 months.
After successful ramus block graft, 2 implants were installed to replace the missing upper central incisors.
FAQ on ramus block graft
Why do I need ramus block graft ?
Shrinkage of bone will occur if the tooth has been lost for a long period of time. Ramus block graft is usually used for the upper front part of the jaw when the bone is so thin that dental implant placement will not be possible without bone grafting.
Can I use artificial bone graft materials instead ?
In cases with very thin bone , using your own bone ( harvested from the back of your mouth ) will provide the best chance of bone formation for placement of dental implants.
Is ramus block graft for dental implants a major procedure ?
Ramus block graft t is a minor surgery that can be done under local anesthesia in the clinic. You can go home the same day as there is no need for any hospital stay. For patients who are more anxious about the procedure, the surgery can be done under sedation in the clinic. The advantage of sedation is that you will feel relaxed and will be unaware of the whole procedure
How long is the bone grafting procedure ?
The bone grafting is very much like a wisdom teeth removal surgery and usually takes 1 -2 hours depending on the complexity of the case.
Is the bone grafting process painful ?
There is no pain during the procedure .However during the immediate post op, there will be some mild discomfort . There will also be some swelling which will subside after a week.
Is ramus block bone grafting a reliable procedure ?
Ramus block graft has been done for dental implant placement since the 1980s . It is a proven method of bone grafting with many long term studies showing dental implant survival rate of greater than 90 percent.
Contraindications for ramus block graft
1) poor oral hygiene
2) Untreated gum disease in the adjacent teeth
3) Dr y mouth
4) Severe habit of grinding teeth
5) Close proximity of the lower jaw dental nerve
6) Chronic liver, kidney diseases
7) Uncontrolled diabetes.
8) Uncontrolled hypertension
9) Undergoing chemotherapy or radiotherapy for treatment of malignant tumours.
Special post op care for sinus lift bone grafting.
1) Complete your course of antibiotics as prescribed.
2) Ice pack for two days to reduce swelling
3) Soft diet for a few days following your surgery eg porridge , noodle soup , soy milk , yogurt etc
4) Avoid biting on the surgical site for 3 weeks
5) Rest at home for a day or 2 and avoid strenuous exercise.
6) If you are a smoker, avoid smoking or reduce smoking for as long as possible.
7) Good oral hygiene is important. Rinse your mouth with chlorhexidine mouth rinse 2-3 times a day .
