A sinus lift is necessary when there is inadequate bone present to support an implant in the upper back area of the mouth. This usually occurs when a tooth is removed from this area, causing the maxillary sinus to “drop” into the extraction site (also known as “pneumatization”). This sinus “drop” reduces the amount of bone available to support an implant.
If a tooth dies, an alternative to root canal therapy is to have the tooth extracted. If a tooth is non-restorable (most of the tooth has been destroyed by decay or trauma), extraction may be the preferable course of action.
It is important to remove all parts of a tooth when performing an extraction. There are thousands of tiny fibers that attach the tooth to the surrounding bone.
These fibers are known as the periodontal ligament, or PDL. If the PDL is not removed, it may harbor bacteria that could lead to cavitational osteonecrosis. As bloodflow is critical to proper healing, Dr. Wall does not use epinephrine (a very potent vasoconstrictor common in dental anesthetics) in any of his local anesthesia techniques.
After the tooth is extracted and all the periodontal ligament fibers are removed, Dr. Wall cleans the site with ozonated saline. Ozone is eight thousand times more bactericidal than chlorine. After cleansing, the Er:YAG laser is used to stimulate bleeding and further sanitize the extraction site.
The site is then filled with platelet rich fibrinwhich is obtained from your blood - nothing artificial - and sutured in place.
If bone does not heal properly, of it there is inadequate blood supply to an area of the jaws, ischemia may occur. The jaws are the third most common area for ischemic osteonecrosis to occur. The most common method for diagnosing ischemic osteonecrosis is by bone density screening on a cone beam computed tomography scan.
Once an area is found (wisdom teeth extraction sites are quite common), the site is opened and debrided. A biopsy is taken to send to the pathologist for definitive diagnosis. A blood sample is also taken to see what type of bacteria were present in the site. Ozone gas is then used to fumigate the area. The Er:YAG laser stimulates bleeding and PRF is used to fill the site.
Ridge Splitting & Bone Grafting
If a potential implant site does not have enough width of bone, one effective grafting technique is the ridge split. This technique allows a narrow ridge to be expanded and receive an implant at the same visit.
Watch Dr. Wall perform a Ridge Split procedure here. This video may be too graphic for some viewers.
If gum disease requires more than a deep cleaning and ozone/iodine treatment, Dr. Wall has the training and expertise to get to the root of the problem. The TwinLight procedure is extremely effective at cleaning periodontal pockets and stimulating healing of diseased areas of the mouth. Where recession has occurred, Dr. Wall is a trained provider of the Pinhole Gum Lift procedure.
The best solution for a missing tooth is a dental implant or implant supported prosthesis. As metals carry an electrical current, it is Dr. Wall’s opinion that only non metal materials should be used in the mouth. For this reason, Dr. Wall only offers zirconia implants.