DTUK1010

23EducationApril 19-25, 2010United Kingdom Edition msc_ad_source_uk.pdf 1 03/08/2009 15:21:59 D ental implants require sufficient bone to be ad- equately stabilised. For some patients, implant treat- ment would not be an option without horizontal or vertical bone augmentation. Therefore, general bone augmentation is an area of immense importance in implantology. A variety of materials and surgical techniques are avail- able for bone augmentation, de- pending on the case and patient – after all, each case is different. One option is a block graft, a bone augmentation technique ideally suited for simply build- ing up bone matter. Firstly, the area to be augmented is meas- ured and then cortical blocks are harvested from either the chin or the ramus of the man- dible. First the area to be aug- mented is measured. After rais- ing a flap from the donor site, a block is cut either by using peizo-surgical instrument or by drilling small holes to trace the outline of the block. A fis- sure bur then links these and the block is separated from the underlying bone using chisels. The donor site can be filled with collagen sponges to aid healing, before being sutured. On the host site, the cortical plate is perforated numerous times to promote bleeding us- ing small diamond burs. The block is then shaped using large burs to fill the void and follow the curve of the dip. Small holes are drilled through the block and the cortical plate to allow for a screw to secure the block in place. Particulate bone can be used around the block and a resorbable membrane draped over the graft. This is left for at least six months before im- plant placement. Non-resorbable membranes A more tricky technique is to use non-resorbable membranes to build up the bone mass. The use of these membranes is tech- nique sensitive and in inexperi- enced hands can easily lead to failures, resulting in the remov- al of grafts. Generally there are two types of commonly used membranes. One of which is titanium rein- forced, while the other is not. In areas of augmentation, xe- nografts alone with these mem- branes cannot be used. In my experience, although the ridge will augment, the quality of bone formed is very poor and unsuit- able for implant placement. It is therefore important to mix autogenous bone and xenografts together with an equal ratio to achieve better results. The auto- geous bone can be taken from the tubrosity or ramus and crushed Horizontal bone augmentation Dr Riz Syed discusses the importance of general bone augmentation in the arena of implantology and some treatment options ‘A variety of ma- terials and surgi- cal techniques are available for bone augmentation, de- pending on the case and patient’ page 24DTà