Ridge augmentation procedures
Tooth extraction is characterized by resorption of the alveolar bone, which reduces the bone volume available for implant placement. The ridge augmentation proce- dures facilitate the preservation of the alveolar architecture to prevent hard and soft tissue collapse and to provide the maximum bone availability and esthetics outcomes for implant placement.
For that reason, a variety of grafting materials have been utilized such as, autogenous bone grafts, allografts, xenografts and alloplastic materials.
Contraindications for ridge preservation are considered in patients irradiated in the area planned for socket augmentation, patients taking biphosphonates and when general contraindications against oral surgical interventions and infections at the site planned for ridge preservation are observed.
Sinus lift procedures
The maxillary sinus is pyramidal in shape. The base of the pyramid is the medial wall of the sinus and also the lateral wall of the nasal cavity, and its apex points towards the zygomatic bone. The roof of the sinus is also the floor of the orbit. The sinus has a non‐physiologic drainage port high on the medial wall (maxillary ostium) that opens into the nasal cavity between the middle and lower nasal conchae.
The maxillary sinus maintains its overall size while the posterior teeth remain in function. It is, however, well known, that the sinus expands with age, and especially when posterior teeth are lost.
Sinus lift surgical procedure includes the elevation of the sinus membrane to create adequate space for placement of a graft material and facilitate future implant placement. Medical or surgical therapy of sinusitis, and removal of polyps and tumors must be completed prior to sinus floor elevation.
Bone augmentation procedures
Horizontal or vertical ridge augmentation of a deficient alveolar bone site is performed either simultaneously with implant placement, or with a staged approach prior to implant insertion.
Horizontal ridge augmentation is usually utilized in the anterior (esthetic) zone in the maxilla and the posterior area in the mandible, while common sites for vertical ridge augmentation are the posterior mandible.
A variety of surgical techniques have been described to enhance the bone volume of deficient implant-recipient sites, such as the use of onlay grafts, ridge splitting, but the most common methods include the use of an intraoral or extraoral graft, with or without coverage by a barrier membrane (guided bone regeneration).
