Bone replacement and regeneration

Difficult initial conditions for implants. What now?

What is bone regeneration?

The prerequisite for secure and permanent anchoring of artificial tooth roots in the jawbone is a sufficient amount of bone at the desired location. Unfortunately, teeth are often lost after gum disease and advanced bone loss. After every tooth extraction, but also after apicoectomies, large defects occur and the bone recedes during the healing process. Therefore, the required bone volume is often not available. Today, this missing bone can be reconstructed using special reconstruction techniques to ensure satisfactory healing.

Our bone takes longer to regenerate than soft tissue. If new bone is to be formed, it is covered with a membrane during several months of growth and protected against the ingrowth of soft tissue. Bone replacement material or your own bone can also support the reconstruction.

According to a recent study, these measures only guarantee success in the context of systematic gum treatment.

Bone augmentation should only be performed after conservative, non-surgical gum treatment to combat chronic inflammation of the periodontium. Otherwise, it cannot be assumed that the bone situation will improve, as the bacteria present can provoke a rejection reaction of the bone augmentation material used.

The modern bone augmentation procedures we perform follow the principles of biologically gentle, microsurgical therapy in order to obtain a newly formed implant bed as minimally invasive as possible, on which optimally positioned implants can be placed.

Only when the “pillars” are optimally positioned can the dentist, in close consultation with the dental technician, produce perfectly fitting crowns and bridges that harmonise with the overall aesthetic appearance.

What requirements should the bone substitute fulfil?

An ideal bone replacement material should have sufficient stability and fulfil 3 basic conditions for new bone formation:


The surface of the material enables the migration and adhesion of connective tissue cells.


The bone substitute attracts the body’s own connective tissue stem cells and causes them to colonise the material.


New bone is actually created permanently in the bone substitute, which slowly takes over the function of the replacement material.
The use of bone replacement material utilises the ability of human bone to regenerate, i.e. to replicate missing bone mass. The newly forming bone requires a support structure that serves as a kind of “template” for the new bone formation.

Which material is used?

The gold standard for replacement material is and remains the patient’s own bone. Depending on the indication and initial situation, however, more bone is sometimes required than the patient can provide, or a second donor site is not desired. Artificial bone materials or industrially purified donor material from humans and animals (cattle) have become scientifically established for this purpose.

Procedure and behaviour

The most important prerequisites for successful surgical treatment are a gentle approach and the utmost care when working with the hard and soft tissue. Our doctors act according to these principles within the framework of a minimally invasive, microsurgical concept.

At Leipziger 14 – Your dentists, we operate with special super-fine instruments. Some of our suture materials originate from vascular surgery and can only be used with 5x optical magnification.

Augmentation methods

Sinus lift – bone augmentation in the maxillary sinus

If the upper jaw bone is too flat, it can be corrected by reducing the size of the neighbouring maxillary sinus so that implants can then be placed. The paranasal sinus is also located in the area of the maxillary bone. In order to restore sufficient bone height, an access to the paranasal sinus can be created laterally after a small gum incision in order to carefully insert bone replacement material. Depending on the size and localisation of the defect in the bone, the surgical site is covered with a membrane and the gums are carefully sutured.
Approximately 6 months should pass after the operation so that the body has sufficient time for the replacement material to grow through the bone. Now implantation is comparatively uncomplicated.
Sometimes, however, the initial conditions are so good that a “one-stage” procedure can be used, in which the bone augmentation and implantation are carried out at the same time.

There are two types of sinus lift: external and internal sinus lift.

In an external sinus lift, a bone window to the maxillary sinus is prepared from the oral cavity and the maxillary sinus mucosa, comparable to the inner skin of an egg, is detached from the floor of the maxillary sinus via this access. Bone or a mixture with bone augmentation material is then inserted into this isolated cavity under visualisation.
In the internal procedure, bone is pressed under the inner skin of the maxillary sinus via the drill hole of the implant, thus enabling the use of longer implants.

Only with such delicate, minimally invasive handling of hard and soft tissue can these complicated surgical procedures be mastered with the greatest reliability.

Socket reservation

This term is used to summarise measures that are applied directly after tooth extraction to prevent volume loss (atrophy) of the bone. It is assumed that by filling the socket with bone substitute material and simultaneously sealing it with membranes or a gum graft, the space can be stabilised in terms of volume.
The early insertion of an implant (immediate implantation) should also be able to stop bone loss after tooth loss. However, this method is only suitable for a few initial situations.

Bone spreading (bone splitting)

This technique is very popular for inserting implants when the alveolar ridge is very narrow and does not allow the implant to be inserted. Particularly in the lower jaw, it is possible in such cases to spread the jawbone using a fine longitudinal incision and special chisels. The implants and the bone replacement material are then inserted.

Regenerative bone augmentation for severe periodontitis

If bone is lost around the teeth due to chronic inflammation, bone augmentation is possible under certain circumstances in the context of such periodontitis.
To do this, the affected gum and bone pockets are either filled with bone replacement materials and covered with special membranes as part of the surgical periodontitis treatment, or biologically active gels are used to stimulate your own bone to grow. Such procedures should always be carried out by specially trained and experienced specialists in order to achieve the best possible result for you.


Put your trust in Leipziger14, a strong and experienced team, and put your smile in our hands

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