Bone augmentation in periodontology.pptx

Periodontal procedure for bone augmentation

1. Bone Augmentation D r. Muhammad Abid Periodontology

2. Surgical implant placement is focused on “prosthetically driven” implant placement for more natural position and emergence of tooth from soft tissue To achieve this, sometime we need to reconstruct or preserve alveolar ridge

3. Reason for alveolar ridge resroption Periodontal bone loss Gingival recession Tooth loss Use of removeable appliance Lead to alveolar as well as soft tissue defect which hinder the placement of implant prosthetic driven position.

4. Localized bone augmentation Aim in reconstruction of alveolar ridge deficiencies May accomplished at teim of implant placement May be best complete bone augmentation to reconstruct the bone prior implant placement Many technique and material can be used for successful outcome

5. Flap management principle Remote incision ( vertical releasing incision one or two teeth away from graft) Full mucoperiosteal lap elevation at least 5 mm beyond the edge of the bone defect Use of a periosteal releasing incision to give the lap elasticity and permit tension-free suturing is essential. This permits complete closure without stress on the wound margins. Removable appliances should not be inserted over the wound for 2 to 3 weeks Wound closure should be done by mattress to approximate CT and interrupted suture to adapt wound edges

6. GBR Similar concept as GTR (Guided tissue regeneration) Used resorbable or non-resorbable membrane to cover the bone graft Autogenous bone graft Allographic bone graft Xenographic bone graft Alloplastic bone graft

7. Autogenous bone graft Autogenous bone graft Particulate bone graft Monocortical bone graft Allographic bone graft DFDBA FDBA Xenographic bone graft Bio- oss Alloplastic bone graft Tri-calcium phosphate, hydroxyapatite

8. Ideal properties of membrane Biocompatibility Space maintenance Cell occlusiveness Good handling properties Resorbabiliyt or ease of removal

9. Bone graft Particulate bone graft Monocortical block graft

10. Vertical bone augmentation A challenge for implant dentistry Result in complication Should consider benefit and treatment option like Implant placement in adjacent site Short implant Cantilevers or conventional brides Pink ceramic use for masking 2 method are implied Guided bone regeneration Distraction osteogenesis

11. Socket shielding or Socket preservation Preservation of alveolar ridge after tooth extraction Op for cases where immediate implant is not feasible A traumatic extraction done with periotome Socket is filled with material and covered with membrane

12. The end is beginning…!