How Do You Know that the Graft Site is Ready to Receive a Dental Implant?
Dr. H. asks:
My treatment sequence for bone grafting after extraction is to wait 3-4 months before going back into the extraction/graft site to place the implant. I generally use Bio-Oss, a bone graft substitute (Osteohealth) and cover the graft site with a resorbable membrane. My question is how do you know that the graft site is ready to receive an implant? Are there clinical signs that I can look for? Is it necessary for me to take a CBVT scan and measure Hounsfields units? Will this provide me with the information I need? What do you recommend?
6 Comments on How Do You Know that the Graft Site is Ready to Receive a Dental Implant?
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Gene
8/25/2009
Bio-oss alone doesnt solidify after 3 mos it is mush. I use dbm mixed with bio os to hold volume and add capo4 powder . I hydrate in tcn saline and hydrate membrane in tcn saline also. I like membranes from cytogenics .it is more rigid and doesnt slump.After 3 mos good type II bone. Good luck
rlmandell
8/25/2009
Bio-oss is a slowly replaced osseo-conductive graft material. Studies on healing show that it takes six months for approximately 50% of the graft to be replaced by bone. Studies have shown that six months is the minimum time for healing prior to placement of an implant. Other studies have shown that graft material remains for years following the use of Bio-oss. The journal Clinical Oral Implants Research has an extensive published data base of articles on Bio-oss and can be accessed on line.
Ryan Horn
8/25/2009
Not sure that a mixing graft material or soaking in TCN is necessary. I use Puros and biogide. I don't have a set amount of time I wait for implant placement. If you graft a large molar socket that had apical infection you will have to wait longer than grafting a short rooted premolar. I take an x-ray at 2-3 months and look at density of graft material vs. surrounding native bone. Makes sense to me.
daniel kim
8/26/2009
It depend on size of defect and size implant you want to place because bone formation happen where graft material contact with bone. core of graft material takes long time to become bone.
My opinion, if implant will have contact with own bone augmented bone 3 month is sufficient.
If implant will contact with new bone made with augmented material , give minimun 5 month
Dr.P
8/26/2009
Bio-oss, CaSo4 50/50, doxy 25mg wait 10-12 weeks.
My biggest challenge has been:
Old ladies' maxillas heal very, very slowly.
3 months, after graft. Pilot drill, osteotomes, then NobelActive with screwdriver driver, pushing caudally.
In single sites on the maxilla:
Ladies as above- unless bone is resistant (more than 4 taps per ridge expander)
Men- use drill sequence unless soft
Dr SDJ
8/31/2009
hey isn't that gender bias? :-)
