I have bone loss around one of my two upper central incisors. The tooth looks a little longer than the other central and it has to be extracted. I have been told I need a block graft and an implant, but I don’t like the idea of a second surgery to take a piece of bone from my jaw, and prefer an implant instead of a bridge. Is there another alternative?
These are the alternatives for augmenting the amount of the bone in an extraction site:
1- A Bone Graft with particulate bone, for augmenting the width , or
2- A Block Graft from another area in your jaw (preferable) or from a cadaver, to augment both width and height, which is what you need if your tooth appears longer than the adjacent central.
3- A third alternative is Distraction Osteogenesis, but in that area of the mouth, and because of cosmetic concerns, I doubt it would be acceptable to you.
4- A fourth alternative, which is Crown Lengthening Surgery, I would only consider if your front teeth seem short for your smile because it removes bone from around the teeth.
The last alternative, and the one I would recommend is called Forced Orthodontic Eruption, and it utilizes braces to slowly pull the tooth out, which physiologically brings the attachment (the bone and the gums) with it. This allows the gums to be at the same level, for teeth that look even instead of one longer than the other, and it avoids the need for block graft surgery.
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