Bone / Sinus Grafting

On a daily basis, patients present to Camden Place Dental Practice having been informed by their dentists that ‘there isn’t enough bone’ or ‘there is soft bone’ for implants to work.

With our surgical techniques, protocols and a wide array of different dimensions of implants, we can place implants in most cases! It’s why we believe that ANYONE can have FIXED TEETH, irrespective of their age or bone morphology.

However, if in some situation there is a real need to enhance the bone, we offer the following augmentation procedures where needed

Bone Grafting

Sometimes after a placing an implant, a small dehiscence or void may be left within the bony walls surrounding the implant. If this is so, a small amount of particulate grafting material is moulded to cover the defect. The grafting materials all have excellent success rates and there is no real single preference to which one is used. The selection is made depending on surgeon or patient choices.

Guided Bone Regeneration / Augmentation (performed simultaneously to implant placement)

Sinus Grafting/ Sinus lifting

Block Bone Grafting

When back teeth are lost in the upper jaw, the airspaces in our cheeks – known as sinuses – get bigger at the expense of bone. A simple procedure of placing some bone graft into the sinus enhances the amount a bone that an implant can be placed into.

This is casually known as a ‘sinus lift’ because the bone grafting lifts the sinus to a higher level to accommodate the new bone.

This is rarely used and only needed if a large defect is present within the bone. Usually we find an alternative dental implant solution to avoid this procedure if possible.

When do I need an apicoectomy?

Apicoectomy has long been considered the last resort to save the tooth. This is because, in the past, surgery with its traditional techniques had a lower success rate. In most cases, non-surgical root canal retreatment was the best option, as it had greater chances of saving the tooth.

However, today this is no longer the case. With modern approaches and the emergence of endodontic microsurgery, apicoectomy can be considered a first option in some cases. Its success rates have even exceeded conventional retreatment in some studies (2).

What is an apicoectomy?

An apicoectomy, also known as endodontic surgery or root end surgery, is a surgical approach used to treat a tooth infection. It’s typically the last resort to save a damaged tooth from being extracted.

Apicoectomy is so-called because it involves removing a portion of the tooth apex or the very tip of the root. This is necessary because when a tooth infection progresses, it can spread down to the apex area, causing a condition known as apical periodontitis.

Apicoectomy

Let’s take a closer look at some common situations where an apicoectomy may be needed:

1. Root canal retreatment failure:

If the tooth cannot heal despite well-performed root canal treatment, it often means that it is impossible to reach the entire infection through the traditional way. In this case, surgery will allow direct access to the infection to clear it and help identify the cause of the failure.

2. Technical errors during root canal treatment:

Some professional mistakes can block the tooth’s canal, preventing its complete cleaning and shaping. These errors include the fracture of an instrument inside the tooth, perforation of the root, or the extension of filling material beyond the root tip. All of these factors can lead to treatment failure and the need for an apicoectomy.

3. For anatomical reasons:

Sometimes the tooth canal is too curved or has calcifications – a pulp degeneration process – that makes it difficult to use endodontic instruments properly. This can make the surgical approach necessary to access these hard-to-reach areas in order to clean and fill the entire canals.

4. The tooth carries a well-fitting post or crown:

The first drawback of non-surgical root canal retreatment is that it first requires removing the existing restoration, such as a crown or post.

Now, if you are satisfied with your restoration and it fits very well, conventional retreatment increases the risk of damaging it and further weakening the tooth.By performing an apicoectomy, the dentist can access the infected area of the tooth without disturbing the restoration. This approach can save you time and money and reduce the risk of harming your tooth.

5. Cyst:

A cyst is a fluid-filled cavity that forms at the root tip due to a chronic infection. Sometimes it persists or reappears after root canal therapy. In this case, an apicoectomy may be needed to remove it and prevent its re-occurrence.