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Bone augmentation and sinus lift

There is not always enough bone to adequately hold a dental implant. In this case, bone augmentation is necessary. At our oral surgery practice in 1060 Vienna, you will be treated by our specialist in oral and maxillofacial surgery, Dr. Dr. Felix Wick, who will check whether bone augmentation is necessary in your case during a thorough initial consultation. You are welcome to make an appointment online!

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When is bone augmentation necessary?

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Bone loss due to periodontitis: If gum inflammation persists for a long time, the supporting bone around the teeth can also recede in addition to the gums. Even if the gum inflammation is successfully treated, the bone loss cannot be reversed by itself.
02
Long-term tooth loss: If teeth are missing for a long period of time, the jawbone can shrink or recede at this point, as it is no longer stimulated by the natural strain of chewing.
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Tooth extractions: A tooth extraction in which a lot of bone was removed in addition to the tooth may result in a site with too little bone for a dental implant. Particularly serious are cases in which the tooth extraction was carried out some time ago. In this case, the bone augmentation must be particularly well planned.
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Root apex resection: If the tooth is lost after a root apex resection, bone augmentation is often necessary for an implant. The reason for this is the removal of the bone on the cheek side in order to be able to perform the apicoectomy.

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Injuries: Certain injuries, especially when multiple teeth are lost, can result in the need for bone augmentation prior to tooth replacement with implants.
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Tumors and cysts: Occasionally, tumors or cysts occur in the lower or upper jaw. These should usually be removed, although it may also be necessary to remove the adjacent teeth for safety reasons. As a result, bone augmentation is often necessary to create the necessary bone volume for the restoration of a complete set of teeth.
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Ageing process: Natural bone loss can also occur in the course of the ageing process.

How long does bone augmentation take?

The duration of bone augmentation refers to the healing phase of the newly inserted bone until it is stable enough to firmly insert an implant. In dentistry, this period varies depending on the patient's individual situation and the method used. Here are some general guidelines:

  1. Simple bone augmentation: For smaller bone augmentations, such as those required for single implants, the healing process can take around 4 to 6 months before the implant can be inserted.
  2. More complex procedures: For more extensive bone augmentation procedures, such as sinus lifts or larger bone defects, the healing phase can also take longer (sometimes up to 9 months) before the implant can be safely placed.
  3. Immediate implant placement: In many cases, if the defect is not too pronounced, implants can be placed directly during bone augmentation. In some cases, they can even be immediately restored with a crown. However, this depends heavily on the quality of the bone augmentation and the assessment of the treating dentist.
  4. Individual factors: The duration of the healing process can also be influenced by individual factors, such as the patient's general health, smoking, bone quality and compliance with aftercare instructions.

Good to know: It is important that the bone augmentation is fully healed and the bone is sufficiently stable before implantation is carried out.Careful planning, implementation and aftercare by a qualified dentist or oral surgeon is crucial for the success of the procedure.

How bone augmentation works

Bone augmentation in the dental field typically proceeds as follows:

  1. Preparation: In a separate appointment, a thorough assessment of the findings is carried out, including x-rays to assess the condition of the jawbone. The procedure, risks and possible alternative treatments are discussed in detail so that everything can be well prepared.
  2. Anesthesia: The area is anesthetized locally (using an injection) to avoid pain during the procedure, true to the motto: You can feel that we are working, but it shouldn't hurt.  If necessary, sedation using benzodiazepines or general anesthesia can also be used.
  3. Bone augmentation material: Depending on the type of bone augmentation planned, we have various materials at our disposal, such as the patient's own bone, bone replacement materials or a combination of both. The most suitable material is selected in each case (for more details, see Material and methods).
  4. Insertion of the material: The surgeon makes an incision in the gum to gain access to the bone. In most cases, once the volume of bone required has been estimated, the required autologous bone is harvested directly. In most cases, this is mixed with foreign bone and components from the autologous blood procedure. The bone augmentation material is then placed in the required location and - if necessary - fixed in place with a membrane.
  5. Closure: The gum is sutured over the bone augmentation material without tension to enable safe healing.
  6. Healing phase: The inserted bone now needs time to transform into solid, localized bone or to grow firmly. This usually takes several months, usually between 4 and 6 months.
  7. Aftercare: Regular check-ups and good oral hygiene are crucial to ensure successful healing. For smokers, a significant reduction in daily cigarette consumption is essential to avoid wound infections.

The exact procedure may vary depending on individual circumstances and the technology used.

Bone augmentation and sinus lift

There is not always enough bone to adequately hold a dental implant. In this case, bone augmentation is necessary. At our oral surgery practice in 1060 Vienna, you will be treated by our specialist in oral and maxillofacial surgery, Dr. Dr. Felix Wick, who will check whether bone augmentation is necessary in your case during a thorough initial consultation. You are welcome to make an appointment online!

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What is a sinus lift?

A sinus lift, also known as sinus floor elevation, is an oral surgery procedure that aims to increase the bone volume in the upper jaw, especially in the maxillary sinus area (maxillary sinus). This procedure is often performed when the bone in the upper jaw is too thin to provide sufficient bone volume for the dental implants.

There are essentially two different techniques for accomplishing this:

 

  1. Internal sinus lift: In this procedure, the maxillary sinus floor is carefully lifted upwards by tapping through the drill channel for the dental implant using osteotomes (round bone chisels). This is usually done at the same time as the implant is inserted. This technique requires a minimum bone height of 6 mm and is usually only suitable for the insertion of a single implant. It is decided on an individual basis whether additional bone replacement material is inserted or whether the newly created space alone is sufficient for the implant.
  2. External sinus lift: Here, a bony access to the maxillary sinus is milled laterally above the implant to be placed. The membrane lining the floor of the maxillary sinus is carefully lifted. The bone replacement material can then be inserted. In most cases, the planned implants can also be inserted at the same time. This technique requires a much lower bone height than the internal sinus lift.

Bone augmentation: methods & materials

Both method and material are highly dependent on the amount of bone to be replaced, the location and the patient's individual situation. Bone augmentation is achieved using various procedures in which bone replacement material is inserted into the affected area in order to create sufficient substance for the placement of implants.

In principle, both autologous bone from suitable donor regions or artificially produced, established materials can be used for bone augmentation. In the case of autologous bone, we prefer to use local bone if only a very small volume of bone is required. For larger requirements, the region around the lower wisdom tooth is ideal.

Implantation can be performed either at the same time as bone augmentation or as part of a second procedure. Here too, the situation must be assessed individually depending on the patient and the initial situation. Dr. Dr. Felix Wick will be happy to see you for a no-obligation initial consultation.

Frequently asked questions about bone augmentation

What does bone augmentation cost in Austria?

The costs depend on the size of the bone defect and the cost of the materials used. Several materials are usually used together. In summary, the smaller the bone defect and the less material used, the cheaper the procedure.

Which insurance pays for bone augmentation?

In Austria, bone augmentation is usually a purely private service. The statutory compulsory insurance companies do not usually cover any part of this. Depending on the policy, private supplementary dental insurances pay the costs of the operation in full or in part. If the defect has arisen in connection with an accident, the accident insurance may cover the treatment costs. A precise treatment and cost plan is drawn up individually during the assessment and surgical planning. 

How painful is bone augmentation?

Modern anesthesia methods usually make bone augmentation well tolerable. Taking psychoactive drops (see treatments under anesthesia) also helps to make the operation more pleasant. After the procedure, mild to moderate pain can be treated well with common painkillers. We are happy to prescribe decongestant medication to support this, which indirectly relieves the pain situation.

Is bone augmentation always necessary?

No, bone augmentation is not always necessary before placing implants. If there is sufficient bone in the jaw or alternative treatment methods such as bridges or dentures are chosen, bone augmentation is not required. Furthermore, short implants or implants that are reduced in diameter can sometimes be used as an alternative.