What are the main reasons that patients are told they can’t have dental implants?

Dr. Banks: Most patients who come to me for second opinions regarding dental implant surgery have been told they can’t have dental implants because they “don’t have enough bone”. Many of these patients don’t have enough bone at the time of that appointment, but if they are willing to undergo a minor or major bone grafting procedure first, they can become a candidate for dental implants.

But what does “bone grafting” mean?

Dr. Banks: In a nutshell, bone grafting means to take bone from one source, and to graft that bone, or place it, into an area where there is a bone deficiency. This may be done for many reasons, for example, to reconstruct the jaws when a large portion of bone is removed in the treatment of pathology (i.e., cancer, cysts or tumors) or in the event of a traumatic injury, or a congenital (birth) condition such as cleft lip and palate.

How does this relate to dental implant surgery?

Dr. Banks: Sometimes when a patient has bone loss due to longstanding periodontal disease, and bone grafting done the time of tooth extraction can replace or restore the height and width of the bone. Once the bone graft has healed, then dental implants can be placed. Sometimes, when a patient is missing teeth for a long time, the bone of the jaw undergoes a process called atrophy. This means that the size and bulk of the jaw bone in the area where teeth are missing is diminished over time. Bone grafting on the lower ridge, also called “guided bone regeneration” will correct that problem. In the upper jaw, sometimes the sinus will dip down into the area where teeth are missing. This is routinely be corrected with another grafting technique called a “sinus lift” procedure. Bone can even be prevented by grafting the tooth extractions sockets at the same time as the tooth extraction procedures.

How do I know if I need bone grafting?

Dr. Banks: When you come in for your consultation, I will examine you and review your medical and dental history. We may perform a 3D dental cone beam scan. Using a virtual implant planning software, I will show you right then where implants would be ideally located in your jaws for, and any bone grafting that would need to be done to make that happen. Also I will be able to show you the neighboring teeth, sinus cavity, nerves, or any other structures that we need to consider in planning the best treatment for you. Then I will be able to discuss your options so you can make the best choice for your treatment goals, lifestyle, and I hate to say it, but your pocketbook.

Is bone grafting painful?

Dr. Banks: Most bone grafting procedures can be performed safely and comfortably in the office setting with intravenous sedation or general anesthesia. That way, anesthesia medications as well as local anesthesia (numbing the gums and bone) assure our patients a very comfortable procedure. Minimal to moderate swelling and some discomfort can be expected for a few days afterwards, and our patients are treated with comprehensive medication protocols to manage their post-treatment phase.

Alternatives to grafting

Dr. Banks: Yes, there are implant options other than traditional implant. There are narrow diameter implants that may be used in some situations where the jaw bone is thin. In the past these implants were called “mini implants” and were intended for temporary use. The modern narrow diameter implants are now approved for permanent use. There are also short body implants that may be used in some situations. These implants can be used in certain patient situations where the bone height is too short for conventional implants.

If you have been told that you are not a candidate for dental implants, please see Dr. Banks. With extensive training, expertise and experience in bone grafting and dental implant treatment, she has the solution for you!