5.1 Principles of bone augmentation surgery and bone healing
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Once you have completed this e.tutorial plus, you will
- describe indications for bone augmentation and thus broaden your own spectrum of indications for dental implants (diagnosis and indication),
- identify and evaluate the level of complexity, likelihood of complications, and risk of augmentation surgery, and, furthermore, be able to assess your own surgical limits,
- identify the principles and special aspects of bone wound healing, and understand the importance of the dynamic equilibrium between bone formation and resorption for augmentation surgery.
Bone augmentation serves three main objectives: firstly, it improves function by allowing the implant to be placed in the optimal prosthetic position and axis. Secondly, bone augmentation optimizes aesthetics, since the position of the implant—particularly the bone shoulder on the implant—forms the base for soft tissue. Thirdly, it improves the prognosis of the implant. Bone augmentation enables the implant to be surrounded by solid bone on all sides, thus preventing downgrowth of the junctional epithelium and pocket formation, and permitting selection of sufficiently stable implant hardware. Module 5.1 describes patient selection for augmentation surgery, the SAC classification system, and the consequences and severity grades of alveolar ridge atrophy. Bone tissue formation and the biology of bone healing are described, including a discussion of these processes in the presence of various types of defects. The chapter on the value and use of autologous bone grafts in combination with bone substitute material and other biomaterials is of particular importance.
H. Terheyden, S. Schultze-Mosgau, J. Tetsch, H. Schliephake