Detailed Procedure Guide: Ridge Expansion
Ridge expansion is a very common type of bone graft surgery that must be performed when your jawbone is not wide enough or tall enough to support dental implants.
With this procedure, the bony ridge—the actual jaw bone that supports teeth and implants—is built up, creating an adequate foundation to support dental implants. After these grafting procedures and sufficient healing time, the bone is expanded (built up) and dental implants may be successfully placed. Without this grafting procedure, many patients are poor candidates for dental implants and the overall failure rate can increase dramatically.
There are several different types of bone graft material that can be used for bone grafting and/or ridge expansion. Some of the bone materials used in a ridge expansion can be your own bone (autograph), bone donated from animals like bovine or porcine (xenographs), or even synthetic materials. All of these different materials can be utilized to stimulate bone formation with the ultimate goal being a significant increase in overall bone quality and volume.
In some cases, dental implants may be placed at the time of the procedure, saving a significant amount of healing time.
What is the process for ridge expansion?
In a ridge expansion procedure, surgical instruments called osteotomes are used to expose the bone and insert bone grafting materials precisely so that the patient’s natural bone can grow into the site and support dental implants. In a typical case, dental implants can be placed after 3-5 months of healing has taken place. Bone solidification is absolutely imperative to ensure adequate foundations and successful dental implant for the long term.
How do you determine if you’re a good candidate for ridge expansion?
You may be a good candidate for ridge expansion if your jaw ridge is too thin to allow for the easy or initial placement of dental implants. Keep in mind, there MUST be adequate bone volume to create foundations for dental implants. Without this bone foundation, dental implants cannot integrate and the failure rate increases dramatically. The leading cause of bone loss is tooth loss, though bone loss can also be caused by gum disease or infection.
A ridge expansion procedure has overall functional benefits but also may result in dramatic improvements in cosmetics and healthier oral appearances.
Cost of a ridge expansion
The cost of a ridge expansion depends on a variety of factors, including your dentist’s geographic location and the condition of your jawbone. Dental or medical insurance may pay a portion of the cost, but generally grafting procedures are not covered by dental insurance policies or benefits.
Preoperative advice and tips
Prior to the procedure your implant dentist may prescribe specific medications; s/he may also ask you to stop taking certain medications.
Requirements typically include the following do’s and don’ts:
- Do brush your teeth and rinse thoroughly prior to your appointment
- Do wear loose-fitting, comfortable clothing
- Don’t drink alcohol for at least 24 hours prior to the procedure or within 7 days after surgery
- Don’t smoke for at least 24 hours prior to the procedure or after surgery
- Don’t eat or drink anything prior to your appointment, including water or coffee
It’s important that you follow all of your dentist’s preoperative instructions precisely because each directive is specifically designed to increase the chances of a successful procedure.
Bone density & preoperative scans
A ridge expansion is performed when your jaw is not wide enough or high enough to support dental implants.
Proper diagnosis and pre-procedure planning are essential to a successful ridge expansion. You can expect your dentist to take a detailed history, conduct an oral examination, and take x-rays and a CT scan as part of this process. The imagery allows your implant dentist to study the anatomy of your jaw and produce the best possible plan for your treatment.
Anesthesia: Are you sedated for a ridge expansion?
A ridge expansion is typically performed using a local anesthetic that numbs the treatment area. Depending on the extent of the procedure and your anxiety level, nitrous oxide sedation or intravenous sedation may also be used. It is also very common for patients to request sedation for grafting procedures. You should discuss sedation options with your implant dentist during the consultation phase.
Is a ridge expansion a same day procedure?
Yes, a ridge expansion is completed in one office visit. Unless your initial consult is done at the same time as your procedure, you will have had an earlier appointment in which you received an oral examination and any necessary x-rays or scans. You can also expect to have a follow-up appointment in two to three weeks to check on the progress of healing.
Duration of the process for a ridge expansion
The process of getting a ridge expansion begins with a dental exam and evaluation, including any necessary x-rays or scans. The procedure itself involves widening the oral ridge bone using special surgical tools. The actual procedure generally takes 1-2 hours, depending on the extent of the graft and the complexity of the procedure.
Your dentist will start by placing an incision in your gums to expose the affected bone. Then s/he will divide and widen the ridge bone and place bone graft material in the opening. The grafted material will likely be a donated graft, but it could come from another site in the mouth.
Once the ridge expansion is complete, dental implants can be placed at the site.
Proper upkeep and issues with recovery
If you get a ridge expansion or another graft procedure, you’ll want to follow your dentist’s pre- and post-operative instructions precisely to maximize the chance that your procedure is a success. As with any surgical procedure, there is some risk involved, and potential complications can necessitate additional surgery to rebuild the bone. Potential complications include abnormal bone formation or infection. In the overwhelming majority of cases you will experience nothing more than mild pain and swelling.
Post-procedure tips and advice for proper healing after ridge expansion
Post-procedure care is imperative to successful healing after a ridge expansion. Typically you will experience minor pain, swelling and discomfort following the procedure, and your dentist will likely have you gently bite down on a gauze pad.
Typically implant dentists will advise that you:
- Avoid chewing on the site
- Avoid touching the surgical area
- Avoid pulling on your lip to look at your sutures, which can tear the sutures
- Avoid spitting
- Avoid rinsing your mouth, except to use an antibacterial mouth rinse or to rinse with warm salt water as directed
You also want to avoid using a straw or engaging in any behavior that might cause the blood clot to become dislodged. Smoking is also strictly prohibited as smoking inhibits blood flow and interferes with the healing process. You should also avoid drinking alcoholic beverages for at least a week after your procedure. Finally, you should avoid physical or strenuous activity until your implant dentist tells you it’s permissible.
Pain is generally well-controlled using nothing more than an over-the-counter pain medication.
You should contact your implant dentist immediately if you experience any of the following symptoms in the wake of the procedure:
- You develop a fever
- Swelling or pain increases any time after the first few days
- Bleeding continues after more than 24 hours