Dental implantation with bone augmentation

The bone augmentation procedure for implants belongs to osteoplastic surgeries, during which augmentation (bone grafting) of bone tissue is performed. Augmentation can be vertical and/or horizontal, depending on the direction in which the bone volume needs to be increased.

Bone augmentation surgeries have the general name “osteoplasty” and are used not only in maxillofacial surgery but also in orthopedics, traumatology, and plastic surgery. Thus, bone grafting for implants is not the only task of osteoplasty.

However, it should be noted that the majority of osteoplasty procedures in Kyiv are performed specifically for the purpose of bone augmentation for dental implantation.

Dental implantation is a surgical procedure during which an artificial tooth root is placed into the patient’s bone. Thus, the success of implantation directly depends on the condition of the patient’s bone and the volume of bone availability.

In some cases, due to various reasons, the patient experiences thinning of the jawbone – a deficit of bone availability, which significantly complicates or makes implantation impossible.

Indications for osteoplasty

Contraindications for osteoplasty

To augment bone for an implant, it is necessary to transplant bone material into the future implantation zone. There are many materials used as transplant grafts, but the three most popular remain: autogenous, allogeneic, and synthetic materials.

Of all transplants, autogenous (autograft) works best, but for the success of the operation, it is very important to perform the material harvesting correctly. For example, if harvesting is done in blocks, a piezotome with irrigation must be used to prevent overheating and tissue necrosis. When harvesting material with a scraper in the retromolar space (behind the wisdom teeth), tissue necrosis due to friction is also possible.

For those patients who decide to undergo osteoplasty, we recommend not rushing and considering alternative methods, as well as discussing with the doctor not only the operation but also the material harvesting. Osteosynthesis and the possibility of further implantation directly depend on the quality of the transplant.

Bone augmentation during dental implantation can be performed using not only organic but also synthetic material.

• Bioceramic

Include hydroxyapatite, tricalcium phosphate, and other ceramic compounds that mimic the mineral components of bone tissue.

• Polymeric

Polylactide, polyglycolide, and other biodegradable polymers that provide structural support and gradual replacement of bone tissue.

• Combined

May contain combinations of bioceramic and polymeric components to achieve optimal properties.

Synthetic material

During clinical examinations, it is determined whether dental implantation with bone augmentation is necessary and possible. Such examinations may require not only an X-ray but also a CT scan or 3D scanning.

If the patient and doctor have decided to resort to osteoplasty, the procedure will take place either in two main stages: bone augmentation followed by dental implantation, or in a single stage.

This means that both bone material transplantation and artificial root placement occur during a single surgical intervention. It is believed that such implantation with insufficient bone tissue has advantages in the form of saving the patient’s time and fewer surgical interventions.

However, single-stage implantation with bone augmentation is associated with significant risks. Even a top-level specialist cannot guarantee that the material will integrate during osteoplasty, let alone integrate in the full, predicted volume. Implant placement in this case reduces the likelihood of success, especially with a significant bone tissue deficit.

Thus, the patient not only loses time and money but also receives additional trauma, with the deterioration of an already imperfect clinical picture.

This involves first augmenting the bone for the implant, and then placing the artificial root. The advantages of separating the procedure into osteoplasty and implantation proper include:

• more time for healing;
• the ability to ensure that the osteosynthesis process has begun and there is no rejection;
• a higher probability of success even in cases of pronounced bone deficit.

At “Dr. Osadchiy’s Dental Clinic” we urge all patients to take a responsible approach to health matters. Sometimes saving time and money can result in greater losses. Therefore, if the patient and doctor have decided to proceed with bone augmentation for the implant, it is better to opt for a staged approach.

Osteoplasty is a fairly complex surgical procedure, so the cost of bone augmentation for implantation will predictably be quite high, regardless of which clinic performs the operation. In Kyiv, the cost of such procedures is approximately 20 thousand hryvnias.

It should be remembered that an important factor affecting the cost of bone augmentation for dental implantation is the type of material. We recommend choosing autogenous material, but one should not think that using one’s own material for transplantation will significantly reduce costs. After all, material harvesting and preparation are expensive procedures.

To the cost of bone augmentation for dental implantation, one must also add the cost of the implant itself and the services for its placement, since patients are not interested in intermediate results, and the goal of all procedures is to obtain beautiful teeth that are indistinguishable from natural ones.

Not all patients with a small volume of bone availability are candidates for osteoplasty. Moreover, bone augmentation is not possible in all cases. However, this does not mean that the patient will remain without teeth. At “Dr. Osadchiy’s Dental Clinic” we have both the equipment that allows proper material harvesting and the experience that enables us to perform osteoplasty operations. We use our knowledge exclusively as intended, and more precisely: we perform operations only when there are direct medical indications.

Trying to avoid unnecessary surgical interventions and their negative consequences, we recommend that patients take advantage of an alternative to bone augmentation – short implants of the “plateau” system.

A standard implant measuring 8 to 12 mm can be placed in bone at least 12 mm high and at least 6 mm wide. According to the protocol, the length of the screw implant (artificial root) should equal the height of the crown that will be placed on it. However, the short implants of the “plateau” system that we use can support a crown that is three times larger than the length of the artificial root. For example, a crown 10 mm high can be placed on an implant only 4 mm long. The reliability of fixation of “plateau” system implants is achieved by their greater surface area, not their length.

Thus, where bone availability would be insufficient for placing a screw implant and osteoplasty would be required, short Ultrashort Plateau Root Form Implants can be placed.