What is Bone Leveling?
Bone leveling, also known as alveolar ridge reduction or bone recontouring, is a surgical procedure performed to reshape the jawbone to create a more ideal site for dental implant placement. This technique is primarily utilized when there is excessive bone height or when the alveolar ridge is irregular or too narrow.
The Process of Bone Leveling:
Initial Assessment: The procedure begins with a thorough clinical and radiographic examination of the patient’s oral and maxillofacial structures. This includes evaluating the quality and quantity of the existing bone, often using three-dimensional imaging such as cone-beam computed tomography (CBCT) scans.
Surgical Access: After administering appropriate local anesthesia, a full-thickness flap is typically elevated to expose the bone that requires leveling. This involves making an incision in the gum tissue and carefully peeling it back to expose the underlying bone.
Bone Reduction: Using bone cutting instruments like rotary burs or piezoelectric devices, the surgeon will then carefully reduce and reshape the bone. The aim is to create a leveled, regular alveolar ridge that is suitable for implant placement.
Smoothing and Finishing: Once the desired amount of bone has been removed, the site is smoothed using finer burs to eliminate any sharp edges or irregularities.
Implant Placement: Following bone leveling, the dental implant can often be placed immediately. However, in some cases, a healing period may be necessary before implant placement can occur.
Flap Closure: Finally, the gum tissue is repositioned and sutured back into place, covering the leveled bone and implant site. Healing and osseointegration of the implant then occur over the following weeks to months.
Bone leveling is a valuable technique in implant dentistry, particularly in cases where the patient’s natural alveolar ridge would otherwise make implant placement challenging. It allows for optimal implant positioning, which is crucial for both functional and aesthetic outcomes.
However, it’s important to note that this procedure requires careful planning and surgical skill, as excessive bone removal can lead to a compromised blood supply, implant instability, or inadequate bone volume for the implant. Moreover, the proximity to critical anatomical structures, such as nerves or the maxillary sinus, must always be taken into consideration to avoid damage during bone leveling and implant placement.
