What if you don’t have enough bone for implant placement?
As mentioned earlier, we need to assess the implant placement site in a meticulous manner before proceeding to the first phase which is the surgical phase. This means after the 3D analysis of the implant placement site, we might notice that there is a deficiency in width or height of the bone on that site, which is most of the time can be augmented with bone grafting materials either before the procedure by a separate operation or concomitantly during the implant placement surgery. Whatever was our choice of either situation, proper planning of all steps is the secret behind the successful treatment. This is what I always tell the patient “we have have to examine the site in a three- dimensional manner to avoid surprises and not to discuss the augmentation procedure acceptance, need or costs in the middle of the operation” which was an embarrassing situation sometimes for both parties years ago before the “cone beam CT era” where clinicians were solely relying on the two dimensional radiograph ( panoramic X-ray) to examine the implant site ( no width analysis provided in the X-ray hence the term 2-dimensional.
What is bone grafting?
Bone building up around dental implants have multiple reasons like, making sure that the implant’s threads are all in bone, making sure that the implant position is in the perfect restorative site vertically and horizontally and at last but not the least for aesthetic purposes.
What do we use?
We shall discuss with you the available options for your case, normally we like a mixture of the patient’s natural bone (auto-graft) with synthetic bone particles (alloplastic graft). There are also a couple of sources for bone grafting such as animal or human source which might be preferred in some cases and if we need to use it a full report of the material/materials to be used shall be given to you before and after the procedure.
What is soft tissue grafting?
In some cases the gingiva (gums) in implant placement site might be defective or thin either by hereditary reasons or traumatic ones. On both situations, it is advisable to augment the area with a new additional gingival tissue to support the area and protect it from future tissue recession and implant threads exposure to the oral environment as a consequence. Proper examination and patient education about the situation is very important prior to the start of the treatment.