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Treatment guidelines

Hard tissue augmentation (posterior zone)

Key points

  • Vertical bone gain in posterior maxillae is mainly accomplished with a sinus augmentation procedure, while guided bone regeneration or a fixed crestal bone block serve the purpose in posterior mandibles.
  • Sagittal bone gain in posterior jaw regions is mainly accomplished with a fixed bone block or with particulate bone attached to the buccal plate.
  • Covering membranes are regularly used on grafting materials. Equally good results are seen with autografts, allografts, xenografts and alloplasts.

Digital Textbooks

eBook: Single Implants and their Restoration
Single implants and their restoration
Common causes of alveolar defects include bone resorption due to loss of teeth, infection, trauma, or congenital origin. There may be insufficient height or width of residual bone to permit the placement of dental implants, making bone grafting a requirement prior to implant placement. Without grafting, the implants would have to be placed in anatomically unfavorable locations or have adverse angulations. These locations/angulations compromise can lead to esthetic dissatisfaction, mechanical overload and possibly increase the potential for implant loss.
eBook: Single Implants and their Restoration
Single implants and their restoration
Compared to other areas of the oral cavity, the maxillary posterior edentulous region can present its own set of unique challenges when it comes to dental implant therapy. For example, following extraction of posterior teeth, the bone around the extraction sites undergoes resorption. As bone resorbs, the soft tissue architecture also changes to reflect the loss of underlying foundational bone.
Then, over time another phenomenon takes place. The maxillary sinus begins to enlarge and move downward in the direction of the residual ridge crest. This process of is known as pneumatization or "fourth expansion phenomenon" of the maxillary sinus. In the process, bone density in the affected areas also decreases rapidly along with bone quantity. The net result is formation of the least dense bony regions of the entire maxilla.


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