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In the United States
alone, thousands of teeth are extracted annually,
primarily because of decay, severe periodental disease,
infection, or trauma. The jaw bone that supports
the teeth, "alveolar" bone, which is generally soft
and vascular, often melts away or resorbs following
tooth removal. Such bone resorption can result in
significant cosmetic or functional defects, including
loss of surrounding gum tissue. |
Today, however, bioengineering
has led to simple but effective surgical techniques
that can either totally prevent or greatly reduce
the bone and soft tissue loss that normally occurs
following tooth extraction. This brochure
will introduce you to a simple yet effective procedure
that will help prevent such tissue loss from occuring
following tooth extraction.
Fig. #1A- Gum tissue has
receded resulting in abnormal appearance of front
teeth.
Fig. #1B- Gum tissue has
receded resulting in gaps between teeth.
Fig. #2A- Gum tissue is preserved resulting in normal appearance.
Fig. #2B- Procedure maintains normal gum contour.
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Tooth extraction is one of the most common dental
procedures. Healing of the resulting extraction
socket normally occurs unevenfully. However, even
with completely normal healing, there is often some
resorption or melting away of the surrouding bone,
resulting in less height and width that were present
prior to tooth extraction. In addition, as bone
resorbs the overlying gum tissue also tends to lose
both volume and its normal anotomic form. These
changes can occur anywhere but the most severe loss
of bone and gum tissue tends to occur following
removal of incisor teeth located in the front of
the mouth. |
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| Loss
of bone and gum tissue following tooth extraction
often results in both functional and cosmetic defects.
Such tissue loss often results in an unsightly collapsed
appearance, especially in the front of the mouth
where proper maintenance of tissue health is critical
to normal esthetics. In addition, loss of bone and
gum tissue often compromise the dentist's ability
to adequately replace the missing tooth or teeth
with either conventional removable or fixed bridgework
or with a dental implant supported restoration.Sometimes
the loss of bone is so severe that additional surgical
procedures are required prior to replacing the missing
tooth with either a conventional or implant supported
restoration. |
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Today, because of advances in dental surgical procedures
and bioengineering, bone and gum tissue loss following
tooth removal can either be greatly reduced
or completely eliminated. Following removal of the
tooth a specially bioengineered graft material that
helps support bone formation is placed within the
extraction socket. This bone graft material, Bio-Oss®,
with structure similar to human bone, not only supports
new bone growth but also has been shown to preserve
bone and overlying soft tissue following tooth removal.The
Bio-Oss® graft material is then convered with a
natural fiber material, collagen, to protect both
the graft and newly forming bone as well as to help
support and help guide new soft tissue growth. Together,
the Bio-Oss®/Collagen system helps prevent bone
and gum loss following tooth removal. |
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Step #1- Diagnosis of a
tooth requiring extraction
Step #2- Extraction of
the tooth using a gentle surgical technique.
Step #3- Placement of the
Bio-Oss® bone graft material into the extraction
socket.
Step #4- Placement of the
resorbable collagen dressing in densely packed
layers over the Bio-Oss® bone graft and suturing.
Step #5- Temporary restoration
to replace missing tooth and specially shaped
to help support healing of the gum tissue.
Step #6- Final prosthetic
result with fixed bridgework and preserved surrounding
bone and gum tissue.
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| Bio-Oss®
is a safe, effective bone graft material from specially
processed bovine sources. Under the electron microcope,
Bio-Oss® looks very similar to human bone. Because
of its similarity to human bone, Bio-Oss® is
highly successful in helping new bone to form. In
many cases, using Bio-Oss® eliminates the need
for additional surgery to obtain your own bone as
grafting material. |
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| Since
Bio-Oss® is so similar to human bone, it is readily
accepted by our defense mechanisms as a "friendly"
graft and is therefore not rejected. Bio-Oss® acts
as a framework into which bone forming cells, blood
vessels, etc. migrate. As these cells and blood
vessels travel along the Bio-Oss® framework, healthy
new bone is formed and the defect is repaired. |
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| Bio-Oss®
is completely safe. Since it is highly purified
bone, no allergic reactions or infections have been
observed following its use. Every batch of Bio-Oss®
goes through highly controlled processing and sterilization
procedures which remove all impurities. At the end
of these procedures, every batch of Bio-oss® must
pass rigorous tests for purity and sterility, assuring
the total safety of the materials. |
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| Bio-Oss®,
because of its similarity to human bone, is highly
successful in in supporting new bone growth. Although
new bone will begin to form within the first few
weeks after grafting, several months are required
to achieve the quantity and density of bone needed
for further dental or surgical procedures to be
performed. (Time may vary. Ask your dentist about
your specific case). |
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 Bio-Gide®
is a thin resorbable GBR membrane made from the
natural fiber material, collagen. Often when a bone
graft is needed, Bio-Gide® is placed directly over
the grafted material. Bio-Gide® encourages new bone
to form and also prevents the growth of scar tissue
into the grafted site. |
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| Bio-Gide®
is resorbable (melts away) and therefore, unlike
membranes which do not resorb, does not need a second
surgical procedure to be removed. Unlike most other
resorbable membranes which tend to resorb in 4-8
weeks, Bio-Gide® lasts at least 4 months, the time
required for new bone to form. And lastly, during
healing, if an opening occurs in the gum tissue
covering Bio-Gide®, the opening will tend to close
spontaneously, allowing bone growth to continue.
Removal of the Bio-Gide® membrane is almost never
required. |
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| Bio-Gide®,
like many artificial heart valves, is composed of
porcine derived collagen. Using special processing
and sterilization procedures, Bio-Gide® is made
completely biocompatible and sterile. Every batch
of Bio-Gide® membranes undergoes a series of tests
confirming its purity and sterility, assuring total
safety of the materials. Bio-Gide® is not indicated
for patients with a known history of allergic response
to collagen or procine derived products. |
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View A- Implant in the extraction socket with surrouding Bio-Oss® and temporary crown in place.
Today, instead of replacing
missing teeth with conventional fixed or removable
prostheses, (eg. "bridge or partial denture") dental
implant supported restorations are often considered
excellent alternatives. Depending on the
condition of the remaining extraction socket following
tooth removal or may be placed three or four months
later. In either case, preserving the surrounding
bone and soft tissue with placement of a Bio-Oss®
graft and resorbable collagen dressing can be performed
in a manner similar to the procedure used with conventional
fixed or removabale tooth replacements. When a dental
implant is placed into the extraction socket immediately
following tooth removal, the Bio-Oss® graft
material is carefully packed between the metal implant
and the inner socket walls. In the position, the
Bio-Oss® graft helps support bone growth needed
to stabilize the dental implant, while at the same
time helping to preserve the surrounding bone and
gum tissue (View A). |
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| These
procedures are usually done in the doctor's office
under local anesthesia or local anesthesia with
I.V. sedation or occasionally general anesthesia. The procedures themselves are without pain. Post-operatively,
there may be some swelling and mild to moderate
discomfort. Your doctor will prescribe an oral analgesic
to help relieve your discomfort. |
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| Generally,
the same prudent care required after any dental
surgical procedure will be sufficient following
tooth extraction and bone preservation procedures. The area must be kept clean, often with the help
of a prescribed mouth rinse. An antibiotic, if prescribed
by your doctor, must be taken. Antibiotics, however,
are not always required. Undue pressure over the
graft extraction site must be avoided until new
bone is well on its way to being formed. And finally,
brush and floss your teeth as you normally do. However,
avoid the gum tisuues surrounding the grafted extraction
socket until they are well healed (usually about
six weeks). |
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