Jawbone reconstruction from own bone – optimal basis for stable dentures

A solid and sustainable dental implant requires a sufficient bone base so that the implant can grow safely into the bone and remain there for a long time.
Larger defects or extremely thin or low jaws can lead to an insufficient bone structure, which is no longer sufficient for a sustainable dental implantation. In these cases, it may be necessary to first rebuild the height and width of the jawbone before a dental implantation, thus creating a solid basis for a dental implant.
For this purpose, after a detailed clarification using the most modern diagnostic procedures, we resort to bone augmentation with the patient’s own bone and use the body’s own bone from the oral cavity.

What exactly is a jawbone reconstruction and why may it be necessary?

Jawbone augmentation is a surgical procedure in which the bone in the upper or lower jaw is rebuilt with the body’s own bones from the oral cavity.

If teeth fall out or are so badly damaged that they have to be removed, the gap can be filled with a permanent dental implant. Dental implants have been very popular for several years now because they offer a stable, sustainable and comfortable solution. The use of metal-free ceramic dental implants also means that they are in no way inferior to the appearance of naturally white teeth, as they are white through and through and exclude any greyish shimmering through or even grey edges on the tooth replacement.
Dental implants are inserted into the jawbone by means of artificial tooth roots, where they grow together with the bone tissue during the bony healing process, thus firmly attaching the implant surface to the bone. This process is also called osseointegration.
For the ingrowth of dental implants, however, a good and solid foundation is absolutely necessary in order to achieve both a long life and correct functioning of the implant.
To ensure that the dental implant is held as firmly as possible in the jaw, it must be surrounded by a layer of bone at least two millimetres thick.

In some cases, there is not enough bone structure available for a stable anchorage of a dental implant in the jawbone, so that the jawbone has to be reconstructed before the implantation in order to achieve an optimal foundation for the dental implant.

How does bone resorption occur?

If a tooth has fallen out for a longer period of time, bone loss can occur in the edentulous section of the jaw, as the usual stress caused by chewing pressure on the jaw ridge is eliminated at this point. Jaw bones disappear – similar to muscles – as soon as they are no longer needed for a longer period of time. However, mechanical processes, chronic inflammation, periodontitis, osteoporosis, diabetes and cancer can also lead to the jaw bones breaking down.

Dental implants can put physiological strain on and stimulate the jaw bones again, which can counteract the bone loss in the jaw.

What is the procedure for jawbone reconstruction?

The reconstruction of the jawbone is a surgical procedure which is carried out on an outpatient basis in our practice in Berlin Charlottenburg. In addition to a pleasant practice atmosphere, we naturally offer our patients thorough preparation for the procedure.

The diagnosis

For the procedure, we arrange for a blood analysis of our patients in advance. This enables us to identify acute deficiencies or concomitant diseases and to treat the patients in advance in such a way that the healing success after the operation is maximised.
In addition, we clarify the existing bone structure of the jaw bones down to the last detail using digital volume tomography (DVT).

DVT is a state-of-the-art, 3D-based, imaging x-ray procedure that produces precise, high-resolution, three-dimensional images of the head and face, including the jaws and sinuses, at a low radiation exposure. This allows bone structures as well as the course of nerves and adjacent tissue to be assessed accurately. In addition, DVT is also used for the detailed planning of dental implants and it allows the safest and most minimally invasive planning of operations in general.

The entire procedure is discussed in detail with Dr. med. Thomas Franke in a personal conversation. Of course, wishes and fears can also be addressed and taken into account.

The intervention

During the actual procedure, the pain in the affected area is first eliminated, usually in the form of a local anaesthetic. In individual cases or if you are very afraid of the procedure, we can also perform the procedure under deep sleep or general anaesthesia. This is discussed in detail with Dr. med. Franke in advance.
If the anaesthesia works reliably, the operation can begin.
In our practice, we use autologous bone for bone augmentation, since autologous bone material is optimally tolerated by the body. Rejection reactions are generally not to be expected when using autologous bone for bone augmentation, and the healing results are also the best in the long term.

In the first step of the procedure, bones are taken from various regions. As a rule, bone is taken from the mouth area, preferably from the area of the wisdom teeth. But other donor regions can also be considered.
We use particularly gentle and safe ultrasound instruments, so-called piezo devices, for the removal. These spare the surrounding soft tissue by working pressureless, selectively and precisely. The very precise incision can also preserve the bone substance in the best possible way, which is important for the subsequent bone formation and for the healing process of the bone tissue.

Another decisive advantage of piezo surgery is that the procedure can be performed as gently and safely as possible. The ultrasonic oscillations of the piezo devices allow for the most precise and fine incision possible in hard bone tissue. However, in soft neighbouring structures, such as nerves or blood vessels, the ultrasonic oscillations lose their cutting power so that surrounding soft structures are not injured and neighbouring soft tissue is spared. This minimally invasive method also makes wounds as small as possible so that the healing process is promoted.
The harvested bone is then modelled and transplanted to the required location. It is then inserted and covered with PRP membranes.

Platelet rich plasma (also known as PRP) is a proven and highly modern method of enhancing wound healing. The PRP is obtained from the patient’s own blood and the concentrate obtained by centrifugation is injected locally into the tissue in question.

After the operation

During and also after the procedure, we provide our patients with nutrients that are conducive to bone healing. In addition, our patients then receive an individually tailored medication regimen to strengthen the immune system, which ensures the fastest possible regeneration and also optimal healing results.

Of course, we also provide our patients with appropriate painkillers and recommend that they take it easy in the first few days after the operation and cool the affected area sufficiently. Physically strenuous activities such as sports or similar should be avoided in the first few days. Consumption of nicotine and alcohol should also be avoided, as this is extremely disruptive to wound healing and hinders the healing process.

In the following weeks the transplant will grow together with the bone there. After about 3 months this bone can be loaded with a dental implant. Here you can find out more about the implantation. During this time we carry out regular checks to ensure optimal bone healing.