Implant placement requires an adequate bone in the jaw, in order to support the implant (certain height and width). If that is your case, than the procedure is quite easy and common. In case that patient doesn’t have enough bone, it is a job of experienced oral surgeon to solve this by artificial bone placement. Sometimes that is possible, but in other times this doesn’t give desired results.
In cases of insufficient bone quantity, we offer alternatives such as:
•Removable partial dentures
•Metal-ceramic implant-supported bridges
•Increasing the bone by inserting an artificial bone
As we already mentioned, the dental implant implementation procedure, in order to be successful, a particular patient need to have enough bone in the jaw, which is the main support for implants. There are many reasons why someone doesn’t have sufficient bone quantity.
Here are some of them:
Relatively smaller upper jaw and large sinus pneumatization. If this is the case, it means that the implant cannot be placed properly, and or have stability problem. This is not an good candidate for the procedure.
Bone loss due to periodontal disease
When the jawbone is infected the effects of periodontitis can lead to the bone loss, loosening of teeth and tooth decay. An x-ray is the first thing which is needed to us in order to meet the exact situation.
Bone loss after tooth extraction
After tooth extraction the bone around the teeth loses its main function to support the tooth in the jaw. It causes the bone loss, professionally named resorption of the bone. If the procedure of tooth extraction was a complicated one, that the resorption of the bone is larger. According to that, it is desirable that tooth removal be surgical and without trauma.
Few suggestions how to reverse bone loss in teeth:
•Alveolar ridge preservation after tooth extraction
After tooth removal, the natural process is that teeth tend to move in order to adjust. Adjacent teeth starts to move into that empty space. They start to tilt or drift into the missing tooth’s space.
This have a negative effect on the patient’s bite (Malocclusion). Physical symptoms of malocclusion could be severe such as pain, problems with jaw joint, and/or cracking. The picture above present the situation after the permanent tooth extraction (first molar), named tooth occlusion.
A poor on none alignment between the teeth when the jaws are close, see the picture above, push the opposite teeth toward that empty space to the exposure of the root. This is called hypererruption. That is a certain way of tooth decay, it can lead to cavities, hypersensitiveness of the exposed root and in the end periodontitis.
When your back tooth or teeth are missing, the jaw contours tend to shrink and the area for chewing food is reduced. Normally, in that case we use the other side of the jaw more. That way all stress is moved to that other side, more than optimally, which could lead to tooth breakage, loosening and exposure of the root and filling to falls out.
When the patient looses a larger number of teeth, the aesthetic consequences can be quite significant. It can change the shape of your face, the lips and faces have no natural support, the empty space between the jaw is reduced. As a result, the face structure changes. It causes premature wrinkles and create effect that you look older than you are (shown on the picture bellow).
Insertion of artificial bone (tooth supporting bone)
Alveolar ridge is a part of the jaw where all teeth roots are rooted. In cases such as progressive periodontitis or the missing teeth are not treated for a long period of time, than the alveolar ridge is resorbed. Sometimes instead of making denture, and before implant insertion, we are able to preserve alveolar ridge by extending a particular part of the jaw. That way we reconstruct the alveolar ridge again.
This bone modeling process can be done and in other indicative situations, not only before dental implant placement. It is important to mention that on the place of a missing tooth the bone resorbs quickly, plus have a negative influence on surrounding teeth. Patients often choose this kind of a procedure for aesthetic reasons. When the patient decide to compensate the lost teeth by insertion of metal-ceramic bridge and reshaping adjacent teeth, then artificial teeth need to be a considerably longer than the adjacent teeth, given the fact that on that place the bone is resorbed.
Procedure of dental implants placement
(Bone grafting procedure for dental implants)
After separating the oral mucosa (mucous membrane of the mouth), next to do is placing the artificial bone on the alveolar ridge of the particular jaw. The artificial bone could be taken from the same patient or be animal origin, or even combined.
Furthermore, after bone graft we place and fix the membrane with appropriate dental instrument. A membrane is places over the bone and under the gum. Its role is to protect and immobilizes the bone graft. Putting the oral mucosa back to place is the next step.
In this way, placed artificial bone is protected and have time to grow with the patient’s native bone in order to support the implant. After minimum 6 months is everything ready for dental implant placement.
However, if there is enough bone for supporting a dental implant and not enough to cover the implant over its entire length, there is a possibility for implant placement. In that situation it is needed to cover the place which is not have enough bone by inserting artificial bone together with membrane. By this step, we could shorten the waiting time for implant placement.
Bone loss is no longer a contraindication to dental implant placement. Following the latest trends and with constant education and improvement, our clinic offers appropriate procedures, high quality and professional approach. Choose the best possible tooth replacement option.