Bone block grafting surgery – transplantation of patient’s bone block in the area of the resorbed jaw. A piece of bone is taken from the patient’s mandible or chin and attached in the field of the defect. This procedure is carried out when the jaw is hugely resorbed, i.e., the width and height of the jaw are altered, which makes tooth implantation impossible.
The reasons for jawbone resorption:
- After the teeth are lost, the gap in the jaw no longer performs chewing function, and the resorption process starts.
- Periodontitis – the plaque and microorganisms cause infection and damage the tissues surrounding the tooth, and when the tooth is lost, a defect remains present in that area.
- After injuries, when after the impact, not only teeth are lost, but also the bone that surrounds them.
- You are wearing removable dentures.
When is bone block surgery performed?
- First, the doctor, using computed tomography, assesses the quality, height, and width of the jaw. If these measurements are substantially altered, then a bone block transplantation surgery is necessary.
- Bone block transplantation can be performed in any part of the jaw by using the newest surgical methods.
Is it necessary to perform bone block transplantation surgery?
If your jaw is severely resorbed throughout the years since the teeth were lost, but the need for implantation remains, then it is necessary to perform the bone block transplantation surgery. Often it is possible to dispense with more straightforward methods by applying bone graft method; however, there are cases when grafting a patient’s bone is necessary.
The course of bone block transplantation surgery:
- Because of its duration, this procedure is performed under intravenous sedation
- Local anesthetics are applied
- Gums are opened in the area of defect, and it is assessed
- The bone fragment is taken from the other area of the jaw and is attached in the area of jaw defect
- If need be, the transplanted bone gets coated with artificial bone substitute and protective membranes
- The wounds are sutured
What happens to the area from which the bone fragment was taken?
- A blood clot forms in the said area, and later a new bone tissue is formed
- About 70% of bone volume gets restored
- If a large bone fragment is taken, the area of a new defect is filled with artificial bone substitute to restore the most substantial possible volume of bone tissue
- The bone fragment can be taken from the same area after 7-9 months
After the surgery:
- After 7-10 days, the sutures are removed;
- After 4 months an implant is screwed in;
- After 3-4 months a healing abutment is placed, and gingivoplasty is performed;
- After several weeks, teeth impressions are made, and prosthodontics begin.
Useful to know:
- The duration of the surgery is 1.5-3 hours.
- It is painless, and the intravenous sedation eliminates fear.
- After the surgery, as the effect of the painkillers wears off, a sensation of gnawing may be felt, swelling will occur, it reaches the most extreme state on the third day after the surgery
- It is necessary to take painkillers and antibiotics after the surgery (they will prevent the infection from spreading in the wound)
- Smoking significantly worsens the success of this surgery; therefore, it is essential to refrain from smoking for at least two weeks before the surgery, and avoid smoking or reduce it to a minimum for four months after the surgery
- Physical activity, sports, and sauna must be avoided for several days
To what type of patients’ performance of bone block implantation surgery is not recommended?
- For persons who smoke more than a few cigarettes per day
- For persons sick with uncontrolled diabetes mellitus
- For persons sick with systemic diseases of the connective tissue, which disturb microcirculation of tissues
The transplantation of bone block is required only in severe or post-traumatic cases. Over time, the quality, height, and width of the jaw are decreasing rapidly. Then the possibility to screw in implants is low. After the loss of the tooth, it is recommended to consult a doctor immediately, as in such cases, regular implantation is enough, and the timely restored quantity of teeth allows avoiding extra financial expenses and expenditures of time, plus the procedure is much simpler.”