Oral Surgery/alveolar ridge augmentation
QUESTION: What are the surgical techniques for augmenting a horizontally deficient anterior mandibular alveolar ridge for implant placement? I'm missing teeth numbers 23,24,25,26. Which surgical technique is most effective?
ANSWER: Charles - The method to augment the mandibular alveolar ridge is variable and dependent on the patient's bite, the extent of degeneration of the bone and future planned procedures to replace the missing teeth. Saying that, the main method is via exposing the remaining ridge via either a superficial incision on the crest of the remaining ridge or an incision lower on the front portion of the ridge and reflecting the tissue to expose the ridge.
Augmentation is via creating a molded new ridge from natural bone, cadaver bone or chemically created bone matter. The mold is covered and allowed to heal for a minimum of 4-6 months before any attempt to place implants or other dental procedures, such as dentures.
The most effective is the one deemed appropriate for you based on your medical history, the anatomy of the area and the skill of the doctor. This procedure, if not done by a surgeon is often anatomically incorrect and leads to failure or an early loss of the graft.
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QUESTION: Thank you for your answer, does a non-resorbable membrane help reduce invading bacteria after surgery? Would you suggest a membrane be placed over the sutures? How do I shield the site from food and water during healing?
Charles - the membrane is intentionally not waterproof. The membrane should not be placed over the sutures, but covering the graft and below the gum tissue. Shielding the area is difficult but you should only eat very soft food initially for the first few weeks during the healing. You also, if the graft was done properly, should be able to rinse the area after eating with warm salt water rinses.