This month’s Implants Today addresses the important topic of bone grafting as it relates to dental implants. The entire health of a dental implant (or implants) is based on the surrounding bone health. I state the obvious, but what may not be obvious are the factors that contribute to bone health and the factors needed to create bone growth. Dr. Paul Fugazzotto, an Implants Today advisory board member, has contributed an excellent article this month entitled, “Simplifying Regenerative Therapy.” In it, he outlines some of the key principles to successfully regenerate bone. One key principle from this article is the importance of flap design. The flap tissue coverage around a bone graft is imperative for graft success since it allows for vascularization of a graft site and protection of the graft placed. Dr. Fugazzotto’s emphasis on flap design is just one of many key steps to successfully create bone growth for implant placement or to augment bone around a dental implant.
For a clinician to master the task of creating bone growth for implant placement and health, there are a few fundamental principles that should be clearly understood. The first is understanding the morphology of the site being grafted and the remaining walls of bone. The amount of available walls of bone dictate both containment and vascular supply to a graft site. From understanding this foundational starting point, an appropriate graft material can then be correctly chosen for both handling properties and needed osseo-inductive assistance.
Another consideration is whether a membrane is needed at a graft site. The purpose of a membrane is to contain the graft material and to prevent soft-tissue in-growth into the graft. Once again, that is dependent on the material being used and the amount of bone support from surrounding bone. Creating osseous augmentation for implant health requires that clinicians have an understanding of anatomy, materials, and surgical flap design at the surgical site.
In addition to Dr. Fugazzotto’s article, Dr. Charles D. Schlesinger writes about immediate implant placement in the anterior region. This article does a great job in pointing out the principles of bone grafting and anatomical knowledge for success when placing only one implant.
If you have any questions or comments about this topic, or any other subject presented in Implants Today, feel free to contact Dr. Tischler at firstname.lastname@example.org.