I wanted to take a look at what the World Implant Operations says scientifically on this issue and what the latest research suggests.
Short implants for bone deficiencies or longer implants by increasing bone height by doing bone grafting with advanced surgeries. Should I use implants?
One of the points that puts maxillofacial surgeons in a dilemma is the treatment options for patients with limited bone height.
If it is necessary to apply implants to our patient and our patient does not have a sufficiently high bone structure, two We have one option. By performing advanced surgery, it is necessary to increase the bone height to the point where the ideal implant can be placed or to use short implants.
If there is an implant candidate with limited bone height, it is necessary to make a very careful decision, make very good analyzes and apply the right treatment option to the right patient.
SUMMARY OF THE LATEST CONSENSUS REPORT PUBLISHED ON THIS TOPIC
Ideal bone presence that will ensure successful osseointegration is needed for implant-supported prosthesis teeth. The bone to be implanted must be capable of providing successful primary stability (initial adhesion) and must have sufficient volume to completely surround the implant.
An ideal implant length is 10 mm and above. In fact, in the presence of suitable bone, it is much more convenient to use 12 -13 mm long implants. Many studies have shown that the ideal or long implant length is much more successful in long-term retention.
Unfortunately, not every patient has the ideal bone height to apply these implant lengths. In this case, our patient's current bone height, the quality and volume of this bone, as well as our patient's needs, age, systemic condition, smoking habit, area of missing teeth and even our patient's social situation are very helpful in determining the treatment protocol we will use.
TREATMENT OPTIONS IN CASES WITH VERY SERIOUS BONE DEFICIENCY
There is no other option other than bone regeneration in patients with very severe bone deficiency. If bone regeneration is required in an area such as sinus augmentation, very good results are obtained with particle bone grafts.
There is no need to take bone from the patient and create a second surgical field. It is even possible to create very beautiful bone with particulate bone grafts using the GBR method using non-resorbable membranes.
However, if a serious bone augmentation is required in the upper jaw anterior region and lower jaw posterior and anterior region, in this case, the gold standard is autogenous. What we call bone is using our patient's own bone.
Ramus block grafts in the mouth provide more predictable success.
In cases that require much more comprehensive and wider bone, it is possible to achieve the best results by taking a graft from the iliac bone, called the hip bone.
This area is like the body's bone bank and it is possible to harvest enough bone to rebuild the upper jaw if necessary. These surgeries should be performed by very experienced hands and a team that is very knowledgeable about their work. They are performed under general anesthesia and require hospitalization for a few days.
However, there is a group of patients who have bone structure around 6-9 mm, which we call the gray area. In order to reach the ideal implant size in these patients, should vertical elevation surgery or 6-8 mm short implants be chosen?
The published 2015 consensus report showed that bone grafting applications with short implants and long implants have similar successful rates. has. However, bone grafting procedures bring about longer treatment times, longer recovery periods, more complications and additional costs.
In the presence of limited bone, the use of short implants of 6-8 mm seems more logical.
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