Here at the Gentle Dental, with our work, we do not have complications too often, but we have come across one recently, which is worth sharing.
We had taken on a referral case with a very large block bone graft in the front of the mouth for implants.
The block bone graft was secured by screws, which we removed later. This provided an excellent opportunity to yield plenty of bone for the front two implants.
Dr Rifai fitted the patient with a temporary bridge that inadvertently put pressure on the gums after surgery. You do not want to put any pressure on the gums following surgery. In this case, this happened due to a tear on the palate’s clear retaining part of the Essix bridge. Regardless, it had dug into the gum, thus exposing newly healed bone.
This meant that the bone was showing.
How we rectified the problem
Here, we had to really adjust the Essix temporarily to clear out all the bone that was needed.
Please note that this is an open patient case where the full procedure has not been completed.
We have extracted one tooth so that the gap is now two-tooth big.
Then, we purposely overbulked and overbuilt the bone, so there is extra to work with rather than insufficient.
The right thing to do in this situation
Dentists should proceed with caution here as the correct thing to do is not to try and reclose the open wound with stitches – this can make things worse.
It’s not common knowledge that a noncritical, more basic bone socket graft may fill in independently. However, this did not work in this case even though the socket started very small.
At first, the hole was not present, but it grew larger before it shrank down to where the pink gum covered the bone again.
One thing to note about the Gentle Dental is that we are always here for our patients and will do whatever it takes to correct and solve dental issues.
We’ve gone the extra mile with block bone grafts and GBR membrane techniques in this case.
Bone closure technique
We removed a slight bit of the surface bone and drew blood from the patient’s right arm.
With their own blood, special cells in the bloodstream (platelets) were concentrated to make a gel membrane called L PRF.
Then, we placed the L PRF on the open wound and stitched a web to hold it in place.
Over the course of about two weeks, we saw the patient twice more to repeat this process to add more L PRF under the special webbing.
And just like that, the bone graft exposure closed – complication solved, and crisis averted.
How we can help
The Gentle Dental’s dentists, like Dr Ali Rifai, often receive messages from people around the UK with bone exposure or similar complications, where they might have lost their entire bone graft and need to start again.
Our methods usually involve very efficient and natural ways to close wounds and use our expertise to provide solutions to prior bone grafts that were completed with poor technique.
Your comments and questions are welcome.
Call 020 8224 7562.
Dr Ali Rifai
BDS (London) PgCert MClinDent (Implantology)
GDC No. 154456
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