Not Enough Bone?

Not having enough bone can be a contraindication for dental implants.  However, in many cases, bone can be augmented to allow placement of an adequately sized dental implants.  Bone augmentation or grafting can be risky and unpredictable sometimes.

If there is not enough width of bone in the upper jaw, bone can be augmented quite easily.  I should not say augmented because I am going to talk about bone expansion in the upper jaw.  The upper jaw or maxilla is quite easy to expand at the time of dental implant placement.  After adequate anesthesia, or numbing, the gum is separated from the underlying bone at the implant site.  Then, the bone is drilled as in a standard case, but before reaching the final drilling diameter, the bone width is sequentially expanded using expanding screws.  The diameter of the proposed implant size and available bone will determine the exact sizes of the expanding screws to be used.  Then final drill is used before the insertion of dental implants.

Bone expansion in the lower jaw is not quite predictable because the lower jaw bone is too dense and hard for gentle expansion.  Will all upper jaw cases require and or allow bone expansion?  May be not.  Ask your dentist more about bone expansion in the upper jaw.

Reader Questions Answered

Question:  Are dental implants always better than a bridge  or denture?

Answer:  In many cases, dental implants are better than bridges or dentures, but not always.  In some cases, bridges or dentures can be better solutions than dental implants.  Dental implants offer a great alternative to the traditional dental bridges or dentures since dental implants do not require altering the adjacent teeth.  However, in the front areas, dental implants sometimes can compromise aesthetics.  In some cases, where there is a defect in the jaw bone, it is easier to camouflage the jaw bone defect with the use of bridges or dentures.  Or with severe space discrepancy, dental bridges or dentures can be better solutions than using dental implants.

Question:  Can a dental implant be placed immediately after removing a tooth?

Answer:  Yes, a dental implant can be placed immediately after removing a tooth, but only under certain conditions.  We have to remember that dental implants are held in place by bone.  It is especially important to achieve the stability right after placing a dental implant.  In some cases, a tooth socket that remains after a tooth removal will allow a dental implant to be placed firmly, but not in all cases.  Whenever, there is a doubt that the shape or health (presence or absence of infection in the bone at the time of tooth removal) of bone after removing a tooth, the placement of a dental implant should be delayed until the bone has healed adequately.

Thanks for your questions.  Please keep them coming.