Sometimes it is necessary to extract a tooth. This can happen for a variety of reasons. Extractions are commonly performed in cases where a deciduous “baby” tooth is reluctant to fall out, a severely broken down and non-restorable tooth is present, or “wisdom tooth” is poorly positioned and unable to fully erupt into place.
To reduce any anxiety and insure patient comfort whenever a tooth extraction is necessary, the procedure, the post surgical instructions, as well as any restorative follow-up care will be carefully and completely explained.
Bone loss in the jaws and around the teeth can be the result of missing teeth, periodontal disease, or trauma. This bone loss is more than a detriment to oral health and function; it can also alter facial appearance as the support for the natural contours of the face is diminished.
When a tooth is extracted, the natural stimulation to the underlying bone that is generated by the forces of biting or chewing is lost. The fact of the matter is that bone width can be reduced by as much as 25% in the first year following tooth loss.
By performing grafting procedures, the oral and maxillofacial surgeon can help restore the bone to its original dimensions to maintain facial esthetics, repair the damage caused by periodontal disease as well as facilitate the success of procedures such as the placement of dental implants. A bone graft provides a platform or “scaffolding” for new bone growth and the material for a bone graft can be derived from the patient, other donor sources or be comprised of synthetic, bone-like materials.
Several types of grafting procedures are performed depending upon the particular needs of the case.
A bone graft can be placed immediately upon the extraction of a tooth or some time after tooth loss. Placing a bone graft at the time of tooth removal reduces the amount of bone loss in the area to maintain the hard tissue support that is required for the future placement of a dental implant. When a bone graft is placed awhile after tooth loss, a separate surgical procedure is required to reflect the soft tissue, expose the underlying bone, place a graft and then suture the soft tissue back into place.
For patients lacking a sufficient amount of bone for a dental implant to replace a maxillary back tooth (upper back tooth), a procedure, which is known as a “sinus lift” is performed. During this surgical procedure, the sinus membrane is lifted, and bone graft material is added between the jaw and the floor of the sinus to provide the needed bone height to support a dental implant successfully.
In addition to bone grafting for purposes of ridge preservation or augmentation to allow for dental implants, an aesthetic ridge augmentation procedure to restore the natural contours of the bone is sometimes performed in preparation for fixed bridgework to achieve a more cosmetically pleasing result.
To guide tissue regeneration as well as protect the graft and promote healing, the oral and maxillofacial surgeon may place specialized membranes and biologically active materials over the grafting material.