Bone Regeneration

Ridge Modification


Ridge modification is an effective procedure for treating deformities in the upper and lower jaws. These deformities can occur as a result of periodontal disease, trauma, injury, wearing dentures, or developmental problems. Such defects can leave insufficient bone for the placement of dental implants and an additional unattractive indentation in the jaw line adjacent to the missing teeth.

Types Of Ridge Modification

Soft Tissue 

This type of ridge modification is used for cosmetic reasons involving the front upper teeth, where the ridge is concave.

With this procedure, a small incision is made beside the ridge defect and the tissue overlying the ridge defect is lifted and a thick piece of tissue is placed under the gum tissue. The incision is closed with sutures. The tissue used is donor tissue.

 Hard Tissue

This type of ridge modification is used to rebuild the jaw bone for placement of dental implants, ridge reshaping for dentures, and cosmetic reasons.

With this procedure, the gum is lifted away from the ridge to fully expose the defect in the bone. A bone graft is placed and covered with a collagen membrane secured with one or more tacks. The incision is closed with sutures and several months of healing will be required.

Membranes

There are two types of membranes used for regenerating bone, depending on the severity of the bone defect involved:

  • Resorbable
  • Non-Resorbable

Non-resorbable membranes provide a long-term barrier effect but may be subject to soft tissue opening, membrane exposure, and early infection. 3-4 titanium screws or tac screws are used to stablize these types of membrane. The number of screw or tacs used varies depending on the type of non-resorbable membrane used, the size of the membrane, and the size of bone defect present.

Once the bone has healed, non-resorbable membranes require removal, either before or at the time of implant placement. Examples of these types include Titanium Mesh and Cytoplast Titanium-reinforced membranes

Resorbable membranes are less prone to soft tissue opening and infection but may not function as an intact barrier for extended periods of time. Membrane tacs may be used to stabilize resorbable collagen membrane. These tacks are removed at the time of implant placement.

Post-Operative

Post-operative medications should start the day of the procedure. The first two weeks of healing, the patient should avoid brushing or flossing in the area where the procedure occurred. It is expected to have swelling and discomfort in the area where the ridge augmentation has occurred; however, this varies from each patient. 

Medications are prescribed to reduce the post-operative discomfort and prevent infections. The following medications given include an anti-inflammatory, an antibiotic, and an anti-bacterial mouthwash. Corticosteroids may be given after extensive bone grafting procedures to avoid excessive swelling. 

A minimum of six months of healing time is required. At six months, a new CBCT scan is taken to insure that an adequate amount of bone has formed for implant placement. 

Socket Preservation                                                                                                                                

This procedure involves placing bone in a socket of a tooth that that has been recently extracted. Once the bone is placed, the bone graft is covered with a dissolvable collagen membrane and the gum tissues are sutured together over the collagen membrane with dissolvable sutures. This procedure is usually performed in order to prepare a site for future implant placement.    

 

If you have any questions about ridge modification, please ask your periodontist.