Bone augmentation for dental implants
If there is no longer enough of your own jawbone available for implantation, we can provide sufficient stability with the help of bone augmentation and give you a new, carefree smile.
- Bone augmentation in the upper and lower jaw
- State-of-the-art surgical techniques
- Family practice for 40 years, now in its 2nd generation
Safe bone augmentation in our specialist practice for implantology
If there is not enough bone for implantation, bone augmentation can be performed. Using various surgical techniques, artificial bone substance is applied to the existing jawbone to form a stronger foundation for the implant.
DR. HAGER - Your experienced dental practice for bone augmentation
Modern surgical techniques and the option of having the procedure performed under sedation take all the fear out of bone augmentation today. We would like to assure our anxious patients (link) in particular that bone augmentation is not painful.
As a modern specialist practice for implantology, we also offer our patients modern treatment approaches. A sinus lift in combination with autologous blood therapy, for example, ensures faster ossification and a faster healing process, as the biomaterials used are first mixed with the body’s own cells to activate natural regeneration.
In the following, we inform our interested visitors about the various bone augmentation methods, the surgical procedure and the costs.
“Thanks to our 40 years of experience in the use of bone replacement materials, we are able to react even when there is a severe shortage of bone and thus offer our patients a permanent solution with implants.”
Dr. Michael Hager
Treatment procedure for bone augmentation
The planning meeting
In a detailed examination by an experienced implantologist, the situation is analyzed precisely with the help of 3D scanning, 3D X-rays and LivePlanugs software.
The information obtained on bone quantity and quality enables the DR. HAGER implant specialist can create an exact treatment plan with the right choice of bone augmentation technique at the first appointment.
This plan includes a schedule and the DR. HAGER fixed price guarantee. This means that patients can rely on a capped price offer and leave the practice with a printed fixed-price treatment plan.
The surgery
The procedure varies depending on which technique has been chosen for bone augmentation. Basically, a distinction can be made between one-stage and two-stage surgery.
If foreign material is used, the implant is usually placed together with the bone augmentation.
The two-stage procedure is preferred for bone augmentation with autologous bone. The DR. HAGER | implantologists usually implant with a delay of 3 weeks.
What all techniques have in common is that a somewhat longer healing period of approx. 3-6 months must be observed.
Bone augmentation briefly explained
Dental implants are intended to replace lost teeth. Similar to their natural counterparts, the implants are anchored in the jawbone and grow through biological processes on the jawbone. Unfortunately, there is often little bone available for anchoring implants at the sites intended for implantation.
- Techniques for bone growth have been developed as a result of scientific success. But why does a decrease in bone substance occur in the first place?
- We know pathological changes, e.g. with predominant bone loss (bone atrophy), as osteoporosis or due to inflammation in periodontitis. Excessive bone growth, on the other hand, occurs in tumors, for example.
- In the mouth, for example, you can see the rapid breakdown of bone after tooth removal. There is no longer any stimulus on the bone or any pressure from the teeth in the jaw, which put pressure on the bone through chewing. The dentist then speaks of bone atrophy. If the dentition is used very heavily, bone is built up around the teeth and in the jawbone for stabilization. This bone metabolism is particularly strong inside the bone: in the bone marrow, which is also called cancellous bone due to its spongy structure. The outer covering of the bone, on the other hand, is very hard and shows less metabolism: it is the bone cortex or corticalis. There is a much higher proportion of cancellous bone in the upper jaw, whereas there is more cortical bone in the lower jaw. Experts used to think that implants in the lower jaw would hold better because of the greater hardness. But it's not that simple.
Find out more about our practice in our patient interviews
Testimonials from our patients
How is bone formed in the first place?
During the growth phase and later in the event of bone fractures, bone cells (osteoblasts) are formed from the periosteum (periosteum) and release bone hard tissue into the surrounding area. Surprisingly, bone-degrading cells (osteoclasts) are also equally involved in this process, which also break down the bone again.
The resulting bone is therefore very much alive: it is constantly being built up and broken down. The body can very effectively adapt the amount and density of bone to the current requirements via cell control. This amazing activity of the bone depends on the health of the person. The healthy, intact immune system is behind it. This is why the phase following artificial bone augmentation or implantation is immensely dependent on a functioning immune system. Stressful circumstances for the immune system include smoking, autoimmune diseases, radiation, little sleep and an unhealthy diet such as sugary and fatty foods.
Case studies for bone augmentation
When teeth are lost, the bone metabolism immediately breaks down the surrounding interwoven bone (bone loss, bone resorption), as it is no longer needed. However, if the tooth is to be replaced with an implant, you have to hurry so that there is still enough bone for the implantation (approx. 6 weeks). If the tooth was removed several months ago, it may be necessary to build up the lost bone with a bone augmentation procedure to anchor the implant, depending on the situation. To make such an assessment, the implantologist needs a good manual examination and an X-ray examination. Bone augmentation is particularly often required in the area of the posterior mandible and lateral maxilla (maxillary sinus area).
However, due to the breakdown of bone in periodontitis, bone mass is often missing in all areas. There are special surgical techniques for each region and each type of remaining bone, and different surgeons also prefer different techniques and different types of bone replacement material. For the layperson, this is therefore an unmanageable area. This makes it all the more important to have a detailed consultation for dental implants, possibly including a second opinion. Our implantologists will be happy to provide you with a detailed consultation.
Safe bone augmentation with DR. HAGER
Are you looking for an experienced dental practice for your bone augmentation in the upper or lower jaw? In our dental practice in Bietingen and dental practice in Konstanz we use the gentlest and most modern treatment methods possible for bone augmentation. We will be happy to inform you in detail about the possibilities of bone augmentation.
Different techniques for bone augmentation
For a better overview, four techniques are described in more detail below.
Sinus lift procedure according to H. Tatum 1986
The best-known bone augmentation. The correct name for the procedure is sinus floor elevation, because if the maxillary sinus is too large and the floor of the sinus is too deep after tooth loss, the floor must be raised (elevated). In sinus lift surgery, a so-called window is opened in the lateral maxillary sinus wall using drills, through which the now accessible maxillary sinus mucosa (“Schneider membrane”) is then lifted. Artificial bone replacement material is then inserted into the resulting cavity on the bony floor and, possibly in a later session, the desired implant is inserted with a firm hold (two-stage procedure). After a bone growth period of several months, a large bone tissue with natural, living, fine bone beads has grown at the desired location, the structure of which provides sufficient support for the implant. …
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Every implantologist has developed their own modifications to the sinus lift, e.g. we design the window to be minimally invasive so that as much surrounding bone as possible is available for growth, and as a rule we also place the implants in the same session as the sinus lift (single-stage procedure).
As bone material, the DR. HAGER implantologists prefer to use the body’s own material (plasma-stabilized augmentation technique), otherwise synthetic bone substitute material, artificial bone, to exclude the possibility of germ transmission from animal bone (e.g. bovine bone Bio-Oss). We also do not harvest or remove bone from the iliac crest, as prolonged pain there would hinder walking. This procedure is no longer necessary thanks to our plasma-based augmentation technique. The sinus lift procedure creates high stability for titanium implants and ceramic implants.
Internal sinus lift according to Summers 1994
A modification of the sinus lift described above. In this procedure, the floor of the maxillary sinus is lifted exactly to the floor of the maxillary sinus through a drill hole without cutting through the mucous membrane there and the implant is inserted immediately. The internal sinus lift is safe with only minor bone deficits in the maxillary sinus. Depending on the modification of the procedure, bone material taken from another location is inserted with osteoblasts in front of the tip of the dental implant. In this way, missing bone height is gained with a firm hold using simple means.
Support plastic
Another technique is the so-called overlay plasty. Here, fully synthetic or autologous bone replacement material is also applied directly to the bone site with missing bone. This material must only be in contact with the underlying bone from which the bone cells are to migrate. All other tissue is kept away from contact by inserting a fully synthetic or autologous membrane, as otherwise the much faster connective tissue cells would migrate into the bone replacement material. Of course, no new bone would then form there. Here too, there are countless variations and methods (bone splitting, bone spreading, …), and experts at congresses are already talking their heads off about the materials alone, as are we.
Obviously, it always depends on the biological growth effects of the natural bone, which the surgeon has to make use of. So it is always the body itself that achieves the desired healing …
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possible, the surgeon can only optimize the conditions. Due to the different growth forces and defenses, strong individual differences can always be expected in different patients. However, if necessary, we will use additional measures and treatments to make the procedure a success. The duration of treatment is extended by several months for all bone augmentation procedures, as bone growth has to be awaited.
We are very happy if a patient would like to consult with another implantologist and will of course forward our X-ray images to the patient by e-mail on request. Conversely, many patients ask us for a second opinion, which we are happy to give correctly, professionally and without making false accusations about the colleague.
Plasma-stabilized augmentation technique
The plasma-stabilized augmentation technique is a very safe and highly topical subject, especially in implantology.
A well-known procedure in which efficient and well-tolerated augmentations, also better known as jaw bone augmentation, can be performed. Bone augmentation is particularly necessary for patients who, after extensive diagnostics, are found to have unfavorable bone conditions, for example due to poor bone quality or a lack of available bone. An adequate solution is required for the later planned implantation of a dental prosthesis. In this special biological procedure, the patient’s own blood is used. The blood is taken by the practice staff for further processing. …
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Bone augmentation can begin on the patient at the same time. The procedure is much better tolerated due to the body’s own material, is also rarely rejected by the body and is also of great benefit for subsequent wound healing.
Dr. HAGER | Zahnärzte are therefore delighted to be able to offer this pioneering and outstanding biological bone augmentation technique to patients.
After bone augmentation
Immediately after the procedure
Lawyers and doctors do not agree on the question of fitness to drive after a dental anesthetic injection. We therefore recommend that an accompanying person drives you home. If you do drive yourself, do not overtake and drive very defensively. It is important not to put any strain on the area where today’s treatment took place. For the first few days, it is best to keep your head elevated at night and use the DR. HAGER cooling pack.
After bone augmentation
Cold and blowing your nose
Please do not blow your nose until 7 days after the stitches have been removed. If necessary, you can carefully dab away the nasal secretions with a tissue. Blowing your nose would exert too much pressure on the wound and could in some cases lead to secondary bleeding or undesirable displacement of the bone structure.
You should therefore also avoid sneezing. If there is no other option, open your mouth. This can reduce the pressure on the wound in the maxillary sinus.
After bone augmentation
Post-bleeding
Slight, occasional postoperative bleeding after a bone augmentation procedure can be brought to a halt with the following steps:
- Sit in an upright position.
- Apply pressure to the wound with a sterile cloth handkerchief or a cotton swab.
- Cooling the affected area can also help to stop the bleeding.
After bone augmentation
Brush your teeth
As mentioned above, please do not put any pressure on the area where today’s treatment took place. It is best to wait until the sutures have been removed before cleaning the surgical area; these will be removed after 7-10 days.
After bone augmentation
Pain
We will give you a suitable painkiller (Ibuprofen 400 – you can also get this over the counter in any pharmacy) for any pain that may occur. Please ensure that you do not take any medication containing ASA (acetylsalicylic acid), for example aspirin. These have an anticoagulant effect and can lead to or increase secondary bleeding.
After bone augmentation
When to eat drink?
When the anesthetic has worn off again. Otherwise you may bite your cheek. If possible, do not put any strain on the surgical area. It is best to start by eating soft foods and drinking still water. As soon as your wound has healed sufficiently after a few days, you can eat as usual again.
After bone augmentation
Sport, sauna and solarium
You should wait about a week, as physical exertion and heat could lead to secondary bleeding.
We look forward to seeing you!
Are you looking for advice and professional treatment? Would you like to know which treatment is right for you? We will be happy to advise you and help you further.
The easiest way to do this is to book your appointment online.
and the entire Dr Hager team
Frequently asked questions about bone augmentation
What does bone augmentation cost?
It depends on the individual situation.
What are the different bone augmentations in the jaw?
- Bone augmentation in the area of the maxillary sinus with artificial bone
- Bone elongation
- Support unplasty with autologous bone
When does bone augmentation make sense?
If you want/need implants and the bone supply is insufficient.
How is bone augmentation performed on the jaw?
We will be happy to explain the different bone augmentation methods to you in a consultation.
How long does an implant with bone augmentation take?
The healing time depends on the type of bone augmentation. Between 8 weeks and 6 months.
How well tolerated is bone augmentation?
Very well tolerated, as it consists partly of the patient’s own blood and even the artificial bone crumbs are converted back into the patient’s own bone as they heal.
Does the dentist need special training for bone augmentation on the jaw?
Dr. Hager’s dentists take part in regular internal and external training and continuing education courses and are constantly improving their techniques.
Are there disadvantages and limitations to bone augmentation?
A thin layer of bone is sufficient for bone augmentation. This means that there are generally only contraindications or restrictions in the case of certain pre-existing conditions/medications.
How can the healing of the bone structure in the jaw be supported?
Protect the affected area very carefully.
