What should I do if I don't have enough bone to have an implant?

 


Although the usual alternative options are a removable denture (partial or full) or a fixed bridge attached to natural dentition, these are not always desired or even possible. My oral surgeon and periodontist can sometimes perform grafting procedures that can miraculously add bone to make implant placement possible even for some extremely deficient ridges.

Today my oral surgeon placed three guided implants for one of my patients who had extensive grafting about 4 months ago. He sent me photos of the procedure, and I was extremely impressed. This was the result of diligence for all concerned... My patient helped by not wearing a denture during the last 4 months, even though she had an important family event to go to. Our office helped by sending intraoral scans of the patients preexisting bridge and also fabricating an Essex retainer that could be placed in my patients mouth in order to aid him with his planning and execution. 

My surgeons often play the biggest part in our team effort since they have exceptional skills and a willingness to persevere in this endeavor even though they may require extensive preoperative planning and multiple cone beam scans before and after grafting. 

In the above mentioned case we will wait several months for my patients implants to integrate...Often my surgeons ask me to wait even longer before restoring one of these cases, in order to allow the bone more time to solidify and replace the bone graft with new bone. For some cases I am asked to do a two-stage restoration . First with temporary implant crowns and later with permanent crowns when the bone is even more solid. 

When all goes well a patients ends a long (and fairly expensive)  journey with implant restoration that initially seemed not possible due them not having an ideal site for implant restorations.



from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2025/12/what-should-i-do-if-i-dont-have-enough.html - http://lspindelnycdds.blogspot.com/

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