IMPLANT RECONSTRUCTION OF THE JAWS AND CRANIOFACIAL SKELETON

Full oral rehabilitation with a high degree of success is now possible with osseointegrated implants. Osseointegration is a direct connectio n between living bone and the titanium implant at the level of the lig ht microscope. Osseointegrated implants are currently used to replace single teeth, support fixed bridges and stabilize full dentures. These implants can also be placed extraorally for attachment of facial pros thesis. The surgical technique used to place implants intraorally into jaws or facial skeleton is performed in two stages using a local anes thetic and/or conscious sedation. During stage I surgery, holes are pl aced into the jaw using a series of gradually larger diameter burs unt il the desired diameter and depth of the bony preparation is achieved. The implant is then placed. The implant must remain undisturbed for 4 months for osseointegration to take place. Stage II surgery is then r equired to remove the mucosa over the implant and place the transmucos al abutment. After 1-2 weeks of healing, the restorative dentist can t ake an impression and fabricate the prosthesis. On occasion, it is nec essary to augment the height and width of the atrophic jaw with autoge nous or allogeneic bone grafts prior to implant placement. Bone grafts are sometimes placed on the floor of the nose or the floor of the max illary sinus. Guided tissue regeneration is a technique used to genera te bone within bony defects adjacent to implants. With long-term rates of success (5 years) of 99% for implants placed in the mandible and 9 5% for those placed in the maxilla, reconstruction of the jaws and cra nial facial skeleton with osseointegrated implants has become the trea tment of choice.