BY Wade Robins

You may have decided that you’d like to replace your missing teeth with dental implants instead of dentures, but aren’t sure what is involved. The short answer to that is that it will depend on the current health of the bone into which the implants will be inserted.

Unless your jawbone is healthy, and has not suffered erosion from infection, gum disease, or previous tooth extraction, you will need to have it built up so that it can hold your implants securely. Dental implant bone grafting is a lengthy process, but can usually be done in your dentist’s office.

Your dentist will use either “autogenous” bone, taken from your own body, or a synthetic or artificial bone substitute. Cow bone is also used frequently for dental implant bone grafting. The addition of this bone will stimulate your body to build new bone around it, but with some synthetic materials the body does not respond by producing new bone, and the synthetic material does the job of securing the dental implant.

Methods Of Dental Implant Bone Grafting

There are several methods of dental implant bone grafting; block bone grafting entails removing bone from another part of the patient’s body. Autogenous bone for a dental implant bone grafting procedure is usually harvested from a patient’s hip or chin, implanted in t he area where the tooth is being replaced, and allowed to heal and grow new bone for at least three, and as long as six months. Any bone taken from areas outside the patient’s mouth will have to be removed in a hospital by an orthopedic surgeon, and transferred to the dentist.

Allograft bone used in dental implant bone grafting is taken from cadavers and under the very close supervision of bone banks. This type of bone harvesting has been going on for years and has supplied bone for thousands of medical and dental procedures with no instances of transmitted disease.

Animal bone used in dental implant bone grafting is known as xenograft, which is the term used for any trans-species transplanting. Both allograft and xenograft dental implant bone are foreign substances to a patient’s body and, very infrequently will trigger a rejection.

Regardless of the source of the dental implant bone graft, the object is to stimulate the body’s bone production in the implant area. One way of making sure the bone growth occurs as quickly as possible for the dentist to insert a “barrier membrane” around the newly grafted dental implant bone. This will keep the body’s more rapidly growing tissues which surround the graft from filling in the areas in which new bone is meant to grow.

Performing a dental implant bone graft with bone expansion requires the dentist to use bone expansion tools to separate sections of the jaw bone and insert the bone implant between them; if the bone is already strong enough to secure it, the dentist may place the implant in the opening instead.

When Bone Grafting Is Not Appropriate

If dental implant bone grafts, bone growth, or bone expansion will not provide sufficient support for a dental implant, the patient may have to have a mold taken of his ore her jawbone and a plate inserted to hole the implants.

If you have plenty of bone tissue and the gums and teeth surrounding the area where you want a dental implant are healthy, then you may not have to concern yourself with dental implant bone grafts. But be prepared for an extended period of procedures and healing, and accept that having dental implants is the most expensive way you will find of replacing your teeth.

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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.

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.

Welcome to Loma Linda Implant.

I decided to make a blog on dental implants and other topics in dentistry. I hope to give unbiased opinions and facts about dental implants to the general public. If you are a dental professional, please visit my other blog, Loma Linda Perio, in which I share information on periodontics and dental implants for the dental professionals.

Your questions and comments are always welcome. If you want to request a specific topic on dental implants, please go to the contact page and let me know. I may not be able to come up with an article right away, but I will do my best.