So far we have covered the building blocks that are part of routine implant placement. This has included the initial examination and diagnosis, special x-rays such as CBCT scans, sedation during surgery and what to expect after the implants have been placed. However, for some people, bone loss after the removal or loss of teeth leaves them without enough to secure an implant. There are procedures that can be done if this is the case:
For those who would prefer an easier but slightly slower, solution there are other sources of bone such as bovine (derived from cow), porcine (derived from pig) or synthetic materials that have been specially prepared to make them safe for use in humans. All of these materials, including your own bone, simply provide a scaffold into which new bone will grow in order to be ready to receive dental implants a few months later.
New bone can take anything from 3 to 12 months before it is ready to receive dental implants. Do not be in a hurry to move to the next stage. If you need a large volume of bone it will take longer to mature than a small amount.
Each surgeon will have his or her preferred way of creating new bone. Many of them will also use a supplementary technique called ’guided tissue regeneration’. Using this technique, slow-moving bone cells are given time to fill a space by placing a barrier material between them and the fast moving cells of the soft tissues lining the mouth. This is a ‘resorbable barrier’ that will disappear naturally a few months after it has done its work.
If you need bone grafting, it will almost invariably increase the length of time your treatment will take; however, when successfully applied it will greatly improve the outcome of the implant(s) placed. When used in the front of the mouth it can also allow for creation of much better aesthetics.
Bone grafting requires a considerably higher degree of skill from the operator and is often more complex to perform than the placement of the implant itself.
In certain situations some operators will recommend combining the implant placement with bone grafting and the placement of a barrier membrane all at the same time. This considerably reduces treatment time and can produce results that are difficult to achieve any other way. However, many surgeons will still prefer to carry out bone grafting as a distinct stage, so that the implants are only placed when the bone grafting has been successful.
Whatever method is chosen to improve the bone quantity the time, effort and expense is gene