Glossary

The term “ramus” refers to the branch or arm of a bone, such as in the pubic bone or the jaw bone. The jawbone has two; one ramus on each side that connects with the skull. In the field of implant dentistry, the ramus is of particular significance to bone grafting procedures. Autogenous bone is often more successful than allograft bone during grafting procedures, and the mandibular ramus provides cortical bone that is suitable for building the alveolar ridge after bone loss prior to dental implant placement. Using grafts from the ramus are highly successful and have a number of advantages, including a low morbidity rate and easy intraoral access. Ramus bone grafts need only a short time to heal, maintain their density after implantation, and exhibits minimal resorption by surrounding bone. Complications of a ramus graft include the possibility of damaging the mandibular neurovascular bundle.

Single dental implants are costly and may not be the best option for patients who need multiple teeth replaced. In the case of patients missing an entire set of top or bottom teeth, dentures are often recommended. For patients who do not want to put in or take out their dentures every day and keep them clean, a special stainless steel implant called a ramus frame implant. This device is shaped like a horseshoe and is implanted into the mandible from the retromolar pad on one side all the way to the retromolar pad on the other. The front of the frame is also implanted into the alveolar ridge above the chin, providing three-point stability. A portion of the device will remain outside the gums, which is what the dentures “clip” or “snap” onto. This may be uncomfortable for some patients, who often choose to wear their dentures over the ramus frame with the exception of removing them for cleaning.

One of the biggest contributing factors to the need for periodontal surgery is the loss of bone. In cases where periodontal disease is very advanced, so much bone may be lost that there is not enough to support a dental implant. In this case, bone grafting may be an option. A bone graft involves the implantation of bone tissue from another source into the area needing bone. The graft heals, integrating with whatever existing bone is present and increasing the amount of bone in the area of the mouth where the implant will be. The Ramus Bone Graft uses a patient’s own bone from the mandibular ramus instead of synthetic (lab-created) or donated bone, meaning that this procedure is considered an autogenous bone graft. This reduces the risk of rejection and other potential complications associated with bone grafts from foreign sources, and encourages the body to generate new bone.

A ramus implant, or a ramus frame implant, is a stainless steel denture anchor that is implanted directly into the bone of the mandible. A ramus implant is one of the earlier types of implants and were originally seen in the mid-1970s. Although large and cumbersome, this type of implant had a 91% success rate over a decade post-surgery. The ramus implant is horseshoe-shaped and is implanted into the retromolar pads on both sides of the mandible and in a third area in the alveolar ridge just above the chin in the center of the mandible. The dentures then “snap” or “clip” onto the part of the implant that sits above the gums. When the dentures are removed, the frame can be felt in the mouth, which some patients may not like. Often, patients will only remove dentures from their ramus frame implant when they need to be cleaned or serviced.