Our Dental Specialty Procedures

With decades of dental experience, Dr. Tran and Dr. Nguyen practice general dentistry with focus on specialty procedures in dental implants, smile reconstruction, dental surgery and helping anxious patients through sedation dentistry. Our passion for confident healthy smiles is the core of Pearly Smile Dental.
We invite you to contact us for a free consultation.

Bonegrafting / Sinus Lifts

Bone Graft for Dental Implants

Bone graft is a procedure that is required in cases where you have insufficient bone volume to receive a dental implant. These bone defects or bone deficiencies can be found in 25% of people with missing teeth. Having sufficient bone mass and a stable implant is critical for long term of success!

When is Bone Graft surgery necessary?

Bonegrafting procedure is performed to re-establish an area with enough bone to support implants!

If you’ve had teeth missing for some time and your bone has atrophied or eroded away, a bone graft will be required. By receiving a stable bone graft, the bone replaced and growth that ensues will ensure the longevity and stability of your dental implants.
If you’ve been missing teeth since you were a teenager, you probably won’t have the minimum amount of healthy bone mass needed to support a stable implant!

About The Process and Technology

There are many types of bone grafting material’s which are generally broken down into two categories, those originating from a jar or from your body. Grafts from a jar means that bone material is manufactured in a special process where granulated biomaterials evolve, to act as the scaffold for new bone to form. These biomaterials can come from a human donor , from a cow (bovine), or man-made like the derivatives of calcium phosphate material from coral shells.

The bone graft attaches when a buildup of bio-compatible or donor material is placed in the areas of missing bone. Its purpose is to stimulate or trigger your own cells to start rebuilding bone mass. Over time, these cells will transform the bone grafting material into your own naturally functioning bone. The use of processed bone biomaterials from a jar has been well documented in clinical trials and has an excellent safety and effectiveness record. However, these biological materials can lead to rejection.

Your own body is another source where we can extract bone material for use in the bone grafting process.

These donor sites of choice are from the hip, chin, back of the lower jaw ( ramus) and many other sites in the mouth, including the palate and back of the upper jaw. Generally we strive to minimize using new donor sites and use specialized instruments to extract bone near the areas we are working.

Having some of your own bone is the gold standard because it quickly stimulates your body to form new bone. To tell it like it is, taking bone from the chin or back of your mouth can be painful, you’ll have more swelling and discomfort than using bone from a jar. The bottom line is this, we must make our decision on what method and material is going to be the best for the long term health of your implant.

To minimize any physical discomfort or emotional distress that arises during the bone grafting process, we at Pearly Smile Dental facility are equipped and licensed to administer IV sedation for your added comfort. After surgery you may experience some soreness in the treated area, which can be remediated easily with pain relievers or the application of an ice pack.

Procedure and Recovery

Complex treatments like bone grafting may involve more than a single visit, especially if your particular oral situation is compromised. Therefore, it is import to schedule an initial examination and consultation to learn about the procedure so that you may be able to make an informed decision. After your specific case has been reviewed and analyzed, you’ll be presented a recommended and highly detailed treatment plan and cost breakdown. There will be no additional fees or special hidden costs once your treatment plan has been properly diagnosed, designed and presented.

Managing your discomfort after bone grafting surgery:

It’s a fact, you will experience some discomfort with any oral surgery procedure and the same is true for bone grafts, however, in most cases it will feel no worse than having a tooth removed.

Some patients will have some post op soreness or discomfort which can usually be managed with aspirin, ibuprofen or a prescription pain medication.

Bone grafting procedures normally cause facial swelling, which usually accelerates within a few days post op and then subsides within 7 days or less thereafter. In order to keep swelling and inflammation under control, it’s prudent to ice repeatedly for a couple of days after your treatment. This self-care routine will help stop bleeding and stimulate your healing process by restricting the circulation of blood to your gum tissues. The use and placement of ice packs as stated will also help reduce the chances of a bone graft failure or implant rejection.

What about eating post-op a bone graft procedure?

What you’ll be able to eat the first few days after your bone grafting surgery will depend on the complexity of the procedure. Some patients should be placed on a cold diet while others will be limited to warm soft foods.

When a modified cold diet is recommended after your surgery the following food-drinks will be allowed: Chilled blended soups or other thoroughly blended cold foods (that don’t require chewing), fruit or veggie smoothies, milkshakes, juices or other healthy beverages.

When a modified soft food diet is recommended after your surgery, the following soft foods will be allowed: Cooked cereals, scrambled eggs, pureed fruits, pudding, mashed potatoes.

Common restrictions and advice for recovering bone graft patients:

  • If you recently completed a bone grafting procedure it’s best to sleep on your back with your head raised, elevating your head on a pillow will help keep inflammation down. In addition, this will help reduce the amount of blood that naturally flows and collects near the graft site, this proactive combination will stimulate a quicker recovery. If it’s difficult or you physically aren’t able to sleep on your back, please make sure you don’t sleep on the bone graft side of your face.
  • For the first 48 – 72 hours after surgery it’s mandatory that you refrain from rigorous activity, as too much exertion can disrupt the graft site or open your stitches. When you start feeling more like your normal self, feel free to slowly but surely resume your regular activities.

The recovery process may take up to 6 months in order for your new bone to heal completely, it’s essential that it becomes stable prior to the placement of your implants.

  • During this healing cycle you’ll need rest, good nutrition and must practice excellent home hygiene care in order to realize an optimal recovery.
  • In order for bone growth to occur it requires time and a strong, healthy body to activate the biological process.

The ultimate goal to create the necessary support for your implants to function naturally, to look great and to last a lifetime has a good chance of occurring if you follow the stated recommendations.

No grafts needed when using short implants and mini implant options: At Pearly Smile Dental, we prefer to avoid bone grafts if possible.

The decision to move forward with a bone graft procedure or not, depends on your long term plan.

It is imperative for the success of your implants 20 years from now, that your bone and gums are healthy when you start the process and remain that way.

Shorter implants have shown good success! The standard height was 10mm and is now 8mm, 6mm or less is considered a mini implant. Splinting narrow or short implants is another treatment possibility to avoid the need for a bone graft.

Mini implants which are less than 3mm wide have some valid applications, usually as a final option in the case of circumventing a bone graft procedure. Unfortunately, their use is still plagued with high failure and rejection rates.

New advances such as full arch implant restorations or the well-known All-On-4 or All-On-6 dental restorations are options that can prevent the need for a bone grafting treatment. These high quality and minimally invasive, solutions are provided with the utmost care and precision at Pearly Smile Dental.

If you’ve been told you need a bone graft to support your implant, try not to fret! There are a lot of new high tech procedures and techniques that provide a gentler experience. Do not hesitate to reach out to us with your questions and concerns as we will be happy to share with you our patients experiences.

If you are in Southern California and need clear, professional and experienced advice about bone grafts, feel free to setup a complimentary consultation.

If you live out of the area and cannot visit our clinic prior to your treatment, we will require you email us a full series of your recent X-rays from your local dentist. This is mandatory for us to evaluate your case and provide you with a tentative treatment plan and estimated cost breakdown. This of course would be in lieu of a preferred, comprehensive personal examination and consultation.

Today, our practice is taking our surgical approach to the next level by incorporating “sticky bone” to the armamentarium. Taking a patient’s own blood and spinning it in a centrifuge to harvest “concentrated growth factors” (CGF) allows us to offer an “organic” bone graft alternative to using traditional allografts (other human bone) and xenografts (animal bone) during dental implant placement.

Sinus Lift Procedures

What Is It?

A sinus lift is surgery that adds bone to your upper jaw in the area of your molars and premolars. It’s sometimes called a sinus augmentation. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, the sinus membrane has to be moved upward, or “lifted.” A sinus lift usually is done with local anesthesia in addition to IV conscious sedation.

What It’s Used For?

A sinus lift is done when there is not enough bone height in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed. There are several reasons for this:

  • Many people who have lost teeth in their upper jaw — particularly the back teeth, or molars — do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw.
  • Bone may have been lost because of periodontal (gum) disease.
  • Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.
  •  Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.
  • The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus varies from person to person. The sinus also can get larger as you age.

Sinus lifts have become common during the last 20 years as more people get dental implants to replace missing teeth.

Preparation

The bone used in a sinus lift may come from your own body (autogenous bone), from a cadaver (allogeneic bone) or from cow bone (xenograft).

If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth or body. In some cases, Dr. Tran may recommend bone be taken from the back of the lower or upper jaws or the chin area.

You will need X-rays taken before your sinus lift so Dr. Tran can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan. This scan will allow the doctor to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.

If you have seasonal allergies, you should schedule the procedure when they are not active.

How It’s Done

Under local anesthesia with or without IV conscious sedation, Dr. Tran will retract the gum tissue and expose the bony area. A small, oval window is opened in the bone. The membrane lining the sinus on the other side of the window separates your sinus from your jaw. This membrane is gently pushed up and away from your jaw.

Granules of bone-graft material are then packed into the space where the sinus was. The amount of bone used will vary, but usually several millimeters of bone is added above the jaw.

Once the bone is in place, the tissue is closed with stitches. Your implants will be placed four to nine months later or sometimes simulaneously. This allows time for the grafted material to mesh with your bone. The amount of time depends on the amount of bone needed and your healing capacity.

Follow-Up

After the procedure, you may have some swelling of the area. You may bleed from your mouth or nose. Do not blow your nose or sneeze forcefully. Either one could cause the bone-graft material to move, and loosen the stitches.

Your doctor may give you saline sprays to keep the inner lining of your nose wet and prescribe medicine to prevent congestion and inflammation. You also will be given pain medicine, an antibiotic and an antimicrobial mouthwash to help prevent infection. Most patients have only a little discomfort after a sinus-lift procedure.

You will see the doctor after 7 to 14 days. He will evaluate the surgical site and remove stitches if they will not dissolve on their own. You might be asked to return a few more times to make sure the area is healing properly.

After a sinus lift, you need to wait several months for the bony material to harden and integrate with your jaw. Depending on the grafting material used, implants may be placed in four to nine months.

Dr. Tran have been using proteins called growth factors to help the new bone harden faster and may recommend this additional procedure. Platelet-rich plasma, which contains the growth factors, is taken from your blood before surgery and mixed with the graft that is placed into your sinus.

Are there any risks?

The main risk of a sinus lift is that the sinus membrane could be punctured or torn. If the membrane is torn during the procedure, the surgeon will either stitch the sinus tear or place a patch over it. If the repair is not successful, your surgeon may stop the procedure and give the hole time to heal.

Your dentist can redo the sinus lift once the membrane has healed. This usually takes a few months. A healed membrane tends to be thicker and stronger, which means a second attempt at a sinus lift is likely to be successful. However, other factors also affect success.
Infection is a risk of any surgical procedure. However, this rarely occurs after sinus lifts.
On rare occasions, the existing bone does not integrate with the bony graft material, and the grafted area does not develop a blood supply. If this happens, any implants placed in this area will fail because there is no live bone for them to attach to. If this happens, you can have the sinus lift procedure repeated.

When To Call the doctor:

  • Any swelling or pain gets worse over time. (It should decrease after the first two days or so.)
  • The bleeding does not stop after one to two days.
  • Bleeding is bright red and continuous. (Normal bleeding after this procedure oozes slowly and is dark red with possible clots.)
  • You think the bony material may have been dislodged after sneezing or blowing your nose.
  • Pain does not decrease over time.
  • You develop a fever.

For more information about Bonegrafting and Sinus Lifts and how it can benefit you or someone you know please contact us at (714) 542-8888 today.

Conveniently located in Huntington Beach with easy freeway access.

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