An area of special interest to the NYCOMS team has been the area of reconstructive surgery.
Bone grafting is performed for two primary reasons:
- Repair or correction of an oral defect
- Preparation for dental implant placement
Techniques that we use to rebuild the jaw of patients undergoing cancer resection surgery, or to close the fistula of a child with a cleft lip and palate have all been modified to allow us to use the principles of bone grafting on the level of the implant patient. Typically the patient that requires bone to build the jaw enough to support dental implants can be managed with the use of local grafts. These grafts can be taken from areas of the lower jaw. If more bone is necessary the area of the tibia, the lower leg. This work is done in an office setting.
If a larger area of the jaw needs to be built up, then we can go into the marrow spaces of the hip bone, an excellent site not only for marrow but for cortical bone that acts as a scaffold to shape these grafts. This work is done in a hospital setting.
If the jaw needs to be grafted to allow for implant placement, then the grafted bone will need to mature prior to placing these fixtures into it. Depending upon the bone source and site, healing can take anywhere from 4 months to 8 months to mature.
Patients that are candidates for implants and bone grafting can expect to have several surgical interventions during the course of reconstruction. This is a time consuming effort that will yield a spectacular return to function. A patient that has this type of work is usually in treatment at least 12 to 18 months. For those patients who are impatient, then dentures may be a more expedient solution.