Chapter 80 - Advanced Implant Surgical Procedures

Abstract

The ultimate success of dental implants for any individual patient relies on a multitude of factors, the most important of which is the availability of bone. The loss of teeth, whether caused by disease or trauma, frequently results in severe deficiency of the alveolar bone. As described in Chapter 79, horizontal bone deficiencies are managed quite predictably with localized bone augmentation procedures. However, vertical bone deficiencies can be much more challenging and less predictable. The posterior maxilla is challenging due to a general lack of bone volume and the omnipresent poor bone quality of the area; that is, posterior maxillary bone often consists of a thin cortical shell filled with sparse trabecular bone. Edentulous sites, in any anatomic location, that suffer from significant vertical alveolar bone loss are especially challenging to reconstruct. This chapter reviews advanced surgical procedures used to treat the most challenging type of bone loss, which is a deficiency in vertical bone height. Maxillary sinus elevation and bone augmentation, vertical bone augmentation, and distraction osteogenesis are reviewed. The role of growth factors in bone augmentation procedures is also discussed.