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:
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.