Dental Implants require sufficient bone of good quality and quantity in order for the dental implants to have stability once the implants are placed in the bone.
Generally speaking the human lower jaw has tougher and more dense bone compared to the upper jaw which usually has more softer bone.
Once a tooth is removed, the bone in the tooth socket starts to remodel and resorb and 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 which time soft tissue healing has occurred but a lot of bone loss has not yet occurred. Waiting 6-8 weeks also allows any infection remaining in the tooth socket to be cleared up.
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 and 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 OR Bio-Oss (bovine derived) bone granules OR patients own bone. We will also use a porcine derived Bio-Gide membrane at that point.
Bone augmentation can fail (~25% failure rate) and 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 patients 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 and you can find our more about it on our bone grafting page.
For a better functional and cosmetic dental implant outcome, where needed we always carry out bone grafting. We can use the patient’s own bone, irradiated cadaver bone, synthetic bone or bovine derived bone. If bone grafting is not carried out in cases where it is necessary, it can lead to serious problems for the patient.
Above you can see the case of a lady who presented to us with implants placed in the smile zone that should have had bone grafting but the implants were placed without bone grafting.
As a result the implant threads are exposed and her implant crowns look very long. To hide this, she has to permanently wear a removable plastic gum mask to cover the unsightly implant threads and the very long implant crowns. In such a case, doing bone grafting could have prevented these problems.
We try to avoid this disastrous outcome, by always doing bone grafting around implants that need bone grafting even if that delays treatment for a little while. Our aim is to achieve the best long term outcome and not to rush to complete as many cases as possible.
Our Practice is open seven days a week from 8am till 11pm. You can book a free consultation with one of our experienced dentists by calling 0208 547 9997 or emailing us for further information or to arrange a consultation.