Bone can be lost for a number of reasons. It may be a disease process where an infection has caused the loss of bone, or it may be just caused by wearing a denture for a long period of time. Some people are born without teeth and therefore the jaw does not develop. Whatever the cause, this problem can be remedied. Jawbone can be reconstructed by using your own bone, this has all the components for reconstruction to take place (Cells, hormones and scaffold). Nothing synthetic as of yet, has these properties. The bone that is transplanted is attached to the jawbone where the deficiency is; the two pieces just fuse together as a fracture would, thus the jaw can be reconstructed. Small amounts when required are obtained from the mouth, however larger amounts are obtained from the hip.
In the upper jaw, the ridge provides support for the lip and it is the area where teeth are most visible when somebody smiles. After the teeth are lost, the ridge becomes narrower and there is often insufficient bone for implants. Sometimes however it be comes necessary to widen the ridge using bone expansion with the implants being placed at the same time. On other occasions it is necessary to use a bone graft in this area to make implants possible to achieve a good aesthetic result. Depending on how much bone is needed, bone grafts can be taken from some other part of the mouth or from the hip and fixed into place. The graft is allowed to heal for 2-4 months prior to placement of implants.
In the lower jaw it is quite rare to use grafts. This is because almost invariably there is enough bone in the front of the mouth. The obstacle in the back of the lower jaw is the nerve that runs along its length. In some cases this nerve can be repositioned, so that implants can safely be placed into this area, enabling the entire height of the lower jaw to be used. This technique is devised in order to make sure that no damage is caused to the nerve. The aim is to move the nerve safely out of the way to prevent injury to it while placing the implants. However, there is always a small risk of damage that may affect sensation in the lip, it is important to keep this in perspective. This nerve can sometimes be damaged when wisdom teeth are removed or during other types of surgery in the mouth. If damaged, there is a numb area that you soon get used to. It is essential to remember that this nerve is a sensory nerve; it does not affect the movement of the lip if damaged and will not cause any drooping of the lip. Having said all that, the aim is to move the nerve to stop it from being damaged. Sometimes bone grafts may be used at the same time to further increase the amount of bone, this is when the deficiency is large.
This is obtained under a general anaesthetic by our consultant orthopaedic surgeon. This surgeon is so skilled that almost all our patients leave the next day. Dr Harbhajan Plaha.
The reason your own bone is the best and is most likely to work is because it heals like a fracture. The graft is transplanted on the same day to the mouth and covered by gum. The graft then fuses with the bone in the mouth.
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