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Oral Surgery/Ridge Expansion / Augmentation

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Question
Hi Dr. Teig,
I have lost teeth #19, 20, 29 almost 20 years ago and significant bones lost (resorbed). I want to have implants on these teeth position and I knew that I need to have ridge augmentation with bone graft for both height and width in order to have adequate bone before having the implant. My concern is should I have an OSM or a Periodontist to perform ridge expansion to get this procedure done with higher successful? A friend of mine (general dentist) suggests me to have OSM for my ridge augmentation, but the onother dentist suggests me to see Periodontist for this procedure. Please advise!
Best regards,
Kay

Answer
Kay -  A periodontist is a dentist who is trained to keep the periodontal tissue and its bone healthy.  In doing so he performs cleaning of the teeth, scraping of the teeth and cleaning periodontal pockets. Where the patient has more advanced gum disease with bone loss, the periodontist cleans out the inflamed tissue by scraping into the bone.  If the disease progresses, the involved teeth can be lost.  Replacement of these teeth with dental implants can be performed and these periodontists place implants for these lost teeth after at least 4-6 months to allow the bone to heal.

The oral and maxillofacial surgeon is trained to extract teeth that cannot be saved.  These doctors also perform reconstruction of the jaw bones when they are deformed.  This can involve major surgery to reshape them and reconstruct them so that they work well and allow the patient to live a life with an ability to chew better and eat without any problems.  It will also allow the patient to have their face reconstructed so it looks better and works better.  

So both these doctors know how to do surgery, but the oral and maxillofacial surgeon is more experienced and knowledgeable about the anatomy of the jaws.  The placement of dental implants involve a knowledge of the anatomy of the jaws.  In the lower jaw, there is a nerve in the middle of the bone that needs to be avoided to prevent damage to the nerve and possible permanent numbness.  In the upper jaw, the surgeon needs to know how to avoid damage to the sinus when placing implants.  Since the surgeon operates on both the upper and lower jaw bones and was trained in a hospital for 3-4 years to attain a degree and learns how to work on the jaw bones.

So in my opinion, the oral and maxillofacial surgeon is the appropriate one to place dental implants.  Make sure that the surgeon you chose is a board certified oral and maxillofacial surgeon.  I wish you well and hope the implants work out well to regain your bite.

Oral Surgery

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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