For dental implants to be placed effectively they require sufficient bone. The bone must be of good quality and quantity in order for the dental implants to be stable, secure, and effective.
Generally speaking, the human lower jaw has tougher and denser bone compared to the upper jaw which usually has softer bone.
Once a tooth is removed, the bone in the tooth socket starts to remodel and resorb. After several months, there can be a lot of bone loss in the tooth socket caused by the loss of that tooth.
The ideal time for implant placement is around 6-8 weeks after tooth extraction. At this point the soft tissue has healed, however, most of the bone is still intact. This waiting time also allows any infection to clear up.
Inspection of usable bone
At Pearl Dental Clinic, we usually place our implants 6-8 weeks after extractions. At that time we inspect the bone quality and quantity and there can usually be three scenarios:
- One possibility is that there is insufficient bone present for implant placement. Therefore, we will have to do bone augmentation to build-up the bone in that region. For bone augmentation, we will use either donated human cadaver bone, Bio-Oss (bovine derived) bone granules, or the patient’s own bone. We will also use a porcine derived Bio-Gide membrane at that point. Bone augmentation, in some instances, can fail. The failure rate is around 25%. The bone graft can become infected or become loose and lead to graft failure. In which case it will need to be redone or a different treatment tried. Once bone grafting is carried out we will have to wait around 6 months for the patient’s own bone to grow into it before we can place the implant.
- The second possibility is that the bone is slightly insufficient, in which case we can place the implant and do bone grafting at the same time. We usually use Bio-Oss (bovine derived bone) and Bio-Gide (porcine derived membrane). Along with placing the titanium implant.
- The third possibility is that there is sufficient bone present and we can place the implant without doing any bone grafting. Bone grafting is an important part of dental implantology. For a better functional and cosmetic dental implant outcome, where needed, we always carry out bone grafting.
This example shows the after-effects of implants placed in insufficent bone.
Due to this, the implant threads have become exposed and appear elongated. To hide this, the patient has to permanently wear a removable plastic gum mask. In such a case, doing bone grafting could have prevented these problems.
We try to avoid this disastrous outcome, by always performing bone grafting where necessary, even if that delays treatment. Our aim is to achieve the best long term outcome while taking the time and care needed for each individual case.
Pearl Dental Clinic is open 7 days a week from 9am to 10pm. You can book an appointment by calling us on 0203 750 5300 or emailing us or also by booking an appointment online.