Plastic surgery

Bone grafting - what it is and why it is necessary.

Bone grafting is a microsurgical operation to build up/restore the bone tissue of the upper/lower jaw before dental implantation. Partial dental implantation is impossible without this preparatory stage. The fact is that after the loss of teeth, for one reason or another, the jaws quickly atrophy to the level of the so-called "basal bone". In the case of complete tooth loss, there may remain, as they say, a "narrow hoop" in the lower or "flat pancake" of bone in the upper jaw.

Be careful when choosing a dental clinic for bone augmentation before implantation, as this operation requires expensive equipment and qualified specialists who are proficient in bone augmentation techniques. During bone grafting, the thickness of the bone for screwing in implants is determined. If these requirements are not met, bone atrophy will progress. This will result in lowering of the gum level or implant mobility.

Successful bone grafting requires one or a combination of the following three outpatient procedures:

Preservation of the alveolar ridge or directed tissue regeneration (DTR).
Grafting of a bone graft block.
Sinus lift procedure (used in the presence of insufficiently high bone tissue for implantation of the lateral parts of the upper jaw).

The STR (directed tissue regeneration) bone grafting method.

This method is often used for bone augmentation. It is less traumatic and easier for the patient. With this technique, you can increase the bone in height and width. Also, when using the STR, simultaneous implant placement is possible. With the STR method, bone material is implanted. It can be either synthetic or natural. It is best to use natural (autogenous) bone grafting, so there is no risk of rejection. However, it is necessary to perform an additional surgery to harvest the bone. In addition, bovine bone materials can be used in the case of STR. They are effective, but there is a risk of infection. If synthetic materials are used, they are safe but not as effective as natural materials.

In this method of bone grafting, dental surgeons use a special membrane. It is applied over the implanted bone material. The special membrane isolates the bone material from the soft tissues.

The method of grafting a bone graft block.

This procedure involves the removal of a small block of bone (about 1 cm square) from the lower jaw, and transplantation of this block in the required area of bone tissue. The graft is then attached with one or two tiny screws and covered with a special protective membrane. After that, a long healing process is required. We invite you to watch a video on how this procedure is performed.

Possible complications during bone grafting surgery.

Small tears can occur along the suture line, exposing the special protective membranes. In 80% of cases, this causes suppuration. It is also possible to reject the graft (in the case of з bone block transplantation). This is due to the low rate of vascularization. The dentist must react immediately! It is necessary to remove all materials from under the oral mucosa. Then, after some time, it is necessary to perform repeated bone grafting.

The success of any operation depends on the doctor, in our case, a dental surgeon, by 99%.

Price for bone augmentation for implantation - dentistry "Oleksiuk" Ternopil.

To answer the question of how much bone grafting for implants costs, it is necessary to determine the factors on which it depends. Firstly, each case is individual and the doctor determines the method and scope of the operation itself (the number of teeth to be operated on). Secondly, there are both cheaper and more expensive materials. The entire cost of this operation is discussed with the patient and then approved.

For more information, please call: +38 (098) 130 13 71

Sinus Lift is an operation to build up the bone of the upper jaw.

Sinus lift is a procedure for building up the bone tissue of the upper jaw. The fact is that there is a maxillary sinus in the upper jaw (so to speak, an air cavity). Due to bone deficiency, the implant may fall into the maxillary sinus and not be firmly fixed.

Indications for the sinus lift procedure.

There may be several reasons why the amount of bone tissue in the patient's upper jaw is insufficient to accommodate a dental implant.

The bone may have been damaged as a result of a previous surgical procedure (e.g., a difficult tooth extraction) or periodontal (gum) defects. A common problem is when the size and shape of the maxillary sinus is relatively large compared to the size of the upper jaw. Because of this, the thickness of the bone tissue is insufficient for implantation.

Preparation for the sinus lift procedure.

The bone tissue used in a sinus lift can be taken from your own body (autogenous bone), also allogenic bone or from cow bone (xenograft). If your own bone is used during a sinus lift, it will be taken from other areas of your mouth or body (rarely).

In very extreme cases, the surgeon will remove bone from your thigh or shin (the bone below your knee). You will need an X-ray taken before the sinus lift so that the dentist can study the anatomy of your jaw and sinus. You may also need a special type of computed tomography (CT) scan. This scan will allow the dentist to accurately measure the height and width of your existing bone and assess the condition of your sinus.

If you have seasonal allergies, you should schedule the procedure when they are not active.

How the sinus lift procedure (maxillary sinus elevation) works.

The specific method used by the dentist may vary. But traditionally, this operation is performed as follows:

Using an ultrasonic piezosurgical apparatus and a special nozzle, a small hole is made in the place where the implant will be subsequently installed.
An experienced dental surgeon lifts the bottom of the maxillary sinus, peeling off the mucous membrane.
Bone chips are placed in the created window. After the space under the mucous membrane is filled, the collagen membrane window can be closed, and then the gum is fixed in place with a few stitches.

In some cases, it is possible that the dentist will place a dental implant at the same time as performing a sinus lift. But in most cases, there is a healing period of six to nine months before the dental implant is screwed in.

Sinus lift postoperative period - recommendations.

You may experience swelling after this procedure. You may bleed from the mouth or nose. After a sinus lift, you may sneeze a lot and blow your nose frequently. This can cause the bone graft to move and loosen the stitches. Your dentist may give you saline to keep the inside of your nose moist and prescribe medications to prevent congestion and inflammation.

You will also be prescribed anesthetics, an antibiotic, and an antimicrobial mouthwash to prevent infection. Most patients experience only minor discomfort after the sinus lift procedure.

In 7-10 days, you will meet with your dentist again. The doctor will assess the surgical site and remove the stitches if they do not dissolve on their own. You may be asked to return to the clinic several more times to make sure that the postoperative area heals without complications. After a sinus lift, you need to wait a few months for the bone material to harden and fuse with your jaw.

Depending on the grafting material that was used, implants can be screwed in within 4-9 months. In modern dentistry, specialists have begun to use proteins, growth factors, to help new tissue harden faster.

Complications.

The main risk of sinus lifting is that the sinus membrane can be pierced or torn. If it is not possible to restore it, the dental surgeon stops the procedure and gives it time to heal. This usually takes several months. The healed membrane tends to be thicker and stronger, which means that the second attempt at sinus lift will be successful.

However, other factors also affect success. Infections are a risk for any surgical procedure. After a sinus lift, this is rare. In very rare cases, the existing bone does not engraft with the bone graft material, and the grafted area does not develop a blood supply. If this happens, any implants placed in this area will not take root. In this case, the procedure is repeated.

When to call a specialist after surgery.

Consult a dentist if:

Any lump or pain will get worse over time. (It should shrink after the first two days or so).
Bleeding does not stop after 1-2 days.
Bleeding is bright red and continuous. (Normal bleeding after this procedure slowly stops and becomes dark red with possible clots).
You think the bone material was knocked out after sneezing or blowing your nose.
The pain does not decrease over time.
Your body temperature has risen.

Patients should not be afraid that this procedure will have an adverse effect on their maxillary sinuses or cause chronic sinus pain. Our experience in this procedure is extensive and long. Its use has been commonplace for many years in our clinic.

The cost of sinus lift in dentistry Oleksiuk

Raising the floor of the maxillary sinus (sinus lift) in our clinic costs from 3500 UAH. The price may vary depending on the specific case. In any case, you should not save on your health. Turning to dentistry "Aleksyuk", you can be sure of the quality of the operation. Our clinic is equipped with the latest equipment and dental materials. Our dentists have extensive experience and regularly improve their professional skills.

For more information, please call: (0352) 40 00 08 or (098) 130 13 71

Lip frenulum plastic surgery

Each person has a special bridge on the mucous membrane, which ensures the attachment of the lip to the jawbone. It should not provoke problems when chewing food, cause discomfort when talking. However, sometimes there are pathologies of its development that require the appointment of lip frenulum plastic surgery.

Description of the procedure

Lip frenulum plastic surgery is an operation during which the frenulum tissue is cut. The lip frenulum is a part of the oral cavity that looks like a fold of mucous membrane. It is necessary to ensure the normal fixation of the upper lip to the jawbone. Usually, the frenulum is woven into the gum tissue at a distance of 0.5-0.8 cm from the necks of the anterior incisors. And if the frenulum of the lip goes beyond the areas of the anterior incisors, and the attachment points are not visible at all, then it is considered too shortened. Usually, the doctor detects this pathology immediately during a visual examination. This procedure should be performed when there are indications for it, and only on the doctor's referral.

Why the frenulum of the upper lip is cut.

With normal development of the frenulum, it is possible to freely pronounce sounds, words, perform correct articulation, move the lips, open and close the mouth.

Please note! If there are pathologies and defects in the development of the frenulum, poor lip mobility is observed, problems arise in their functioning, and various external defects appear.

Lip frenulum plastic surgery is needed to prevent such unpleasant consequences as:

The appearance of sucking disorders in children. Usually, in newborns, the upper lip takes a greater part in sucking, and if there are pathologies in its development, then problems may appear during natural feeding.
Problems with the sound of words. When the frenulum is shortened, there are disorders in its formation and pronunciation. Often this pathology causes problems in pronouncing lip sounds and vowels. In these situations, the speech therapist advises to correct this part, and after this procedure, all defects in pronunciation completely disappear.
In adults, a short frenulum can cause malocclusion and problems with chewing food, which can lead to digestive disorders.
The presence of a short frenulum, as well as its close attachment to the margin in the alveolar ridge, can cause the interdental papillae in the space between the anterior teeth to be pulled back. As a result, an area appears in the bone tissue between the areas of the tooth sockets, which is also called a diastema. Additionally, the size of the space between the crowns may increase.
A shortened frenulum causes the gums to pull back, resulting in a gum pocket, calculus deposition, and gum inflammation.
Abnormal attachment can cause tooth instability, exposure of root areas, and increased sensitivity.
If there is a wide frenulum, there is an increased accumulation of food particles and plaque formation on the surface of the teeth;

Correction of the frenulum is necessary not only to eliminate the above unpleasant consequences, but also for preventive treatment of periodontal pathologies and inflammation in the oral cavity.

What are the indications for lip frenulum plastic surgery?

Adjustments are made if there are such factors:

Plastic surgery is often prescribed when there is a gap between the front teeth. In these situations, a wide frenulum interferes with the normal convergence of the incisors to the central area. Due to the fact that increased pressure is constantly exerted, the gap gradually becomes larger and the teeth are displaced in different directions. Also, if the interdental papilla is damaged, periodontitis appears;
is recommended for use during orthodontic treatment therapy. All the soft tissues of the oral cavity, as well as the frenulum of the lip, cause increased pressure on the teeth and provoke malocclusion. If orthodontic treatment therapy is required, the lip frenulum is firstly plasticized;
if there are periodontal pathologies, as well as the risk of their occurrence. Usually, in such cases, a short bridle causes the mucous tissue to tighten at the base of the teeth, which causes root exposure;
plastic surgery of the lip frenulum is recommended in the preparatory period before the placement of dentures. If the frenulum is shortened, it can cause the prosthetic elements to fall off;
Frenulum plastic surgery is recommended in case of problems in pronouncing words, problematic pronunciation of sounds and other diction problems. But only a specialist can determine exactly whether the frenulum of the upper lip needs to be trimmed during the examination.

When it is better to do this procedure.

Despite the fact that cleft lip plastic surgery is considered a fairly simple, easy surgical intervention that does not cause serious health complications, it is imperative to know when it is better to trim. For example, for newborns, this procedure is recommended when there are problems with natural feeding.

Important! It is advisable for children to undergo this operation when they reach the age of five, when the front teeth have erupted 1/3 of the way through. If the lip frenulum plastic surgery is performed during this period, there will be no manifestation of diastema, and the front teeth will grow in a normal position.

Many doctors recommend performing this operation when children are 7-8 years old. During this period, usually the 4 upper incisors are fully grown and formed. This procedure is recommended only for adults and adolescents.

Contraindications.

Contraindications to this operation include the following conditions and diseases:

Presence of chronic pathologies of the oral mucosa.
Not recommended for osteomyelitis.
If there is multiple caries in a complicated form.
When irradiating the head and neck.

There are also general contraindications, including the following conditions:

is not performed in case of cerebral complications;
in case of dysmorphophobia;
correction is not done in case of alcohol abuse;
in case of mental pathologies;
should not be done in case of blood diseases;
in the presence of infectious pathologies in the acute stage;
for chronic diseases;
if there are oncological pathologies;
in the presence of collagenosis, this condition is characterized by a tendency to scarring.

Preparatory procedures before surgery.

In order for the lip frenulum plastic surgery to be successful and all developmental pathologies to be completely eliminated, you need to properly prepare for the operation. To do this, you need to follow these recommendations:

Before the operation, it is necessary to clean and disinfect the oral cavity;
Additionally, doctors may recommend taking tests to help identify the presence of diseases and contraindications;
Sometimes X-ray fluoroscopy is prescribed, but it is rarely performed because the operation is quick and less traumatic;
Before the frenulum plastic surgery is started, the child must be fed. An operation that is performed on an empty stomach is much more difficult to tolerate, and there may be problems with blood clotting.

Ways to trim the frenulum of the upper lip.

There are the following types of trimming:

if the lip frenulum has a narrow structure that looks like a transparent film, and it is not attached to the edge of the alveolar ridge, then phrenotomy or dissection is recommended. With this surgical intervention, an incision is made across the gum, and then sutures are applied along the gum;
if there is a wide frenulum, then frenectomy is recommended, namely its excision. During this type of surgery, an incision is made in the area of the tensioned ridge, and at the same time, the interdental papillae and tissue located in the bone gap between the roots of the spaced front teeth are excised.

Also, plastic surgery of the lip frenulum can be performed with the help of frenuloplasty, during which the attachment point is moved. This type of surgery can be performed in two ways.

Y-shaped frenuloplasty. During this procedure, the fixed frenulum is excised using a scalpel or gingival scissors. Then a diamond-shaped defect is left on the mucous tissue. After that, the cut edge of the mucosal layer is pushed inside the formed area with the help of a dissolver. In this area, it is fixed to the periosteum with a suture with a knotted structure, and then the wound is sutured.

Z-shaped frenuloplasty. First, freezing is performed, then a vertical incision is made that runs through the center. On both sides of it, two oblique incisions are made, which should have an angle of inclination of 60 to 85 degrees. As a result, two triangular-shaped flaps should be formed, but the central cut should go into a horizontal plane. After that, the submucosal tissue is exfoliated along the periosteum with the help of a rasp, and then the horizontal incision is sutured. The flaps are attached to the periosteum with a catgut.

How to care for the oral cavity after plastic surgery of the upper lip frenulum.

Since lip frenulum plastic surgery is a light, quick surgical intervention, recovery after it is quite fast and practically without complications. However, after the anesthetic wears off, unpleasant pain may occur. Therefore, it is important to follow several aftercare recommendations:

Every day, you need to carry out the necessary oral hygiene procedures - brushing your teeth twice a day, brushing your gums and tongue, and rinsing your mouth with antiseptic solutions;
For about two days, you should avoid eating too hot and hard foods;
On the second or third day, you need to visit a doctor who will conduct a postoperative examination.

This is interesting! For patients in adolescence and adulthood, it is additionally recommended to perform special myogymnastics - a set of exercises that strengthens masticatory and facial muscle tissue. The approximate recovery period is about 4-5 days. During this period of time, unpleasant sensations are completely eliminated, and the recovery and disappearance of all sores is observed.