What happens if I do not have enough bone for dental implants?

This question comes up a lot. Many patients are told that they do not have enough bone left to have dental implants placed. Typically they had the teeth removed a while ago, they wore denture for long time, the bone melted away and all that is left now is an eggshell of bone which is definitely not enough to place implants. They cannot tolerate dentures anymore and they seek a change. Many of these patients are told either that they cannot have dental implants and are deemed to life with dentures or they need extensive bone grafting(usually from the iliac crest) which has some questionable results.

There are solutions though. The jaw bone has two kinds of bone: alveolar bone and basal bone. Alveolar bone is softer and resorbs(melts away after teeth are extracted and with time), while the basal bone is very hard and resorbs very little. Also there are some bony structures close to the jaw bone that can be used to support implants. Those are the zygoma bone(cheek bone) and the pterygoid plate(bony plate behind the wisdom teeth). They are very thick and very hard bone(with the consistency of the oak wood comparing with the alveolar bone which has the consistency of the pine wood).

Diagram showing the Zygoma Dental Implants added for posterior support in a patient with "egg shell bone"

Diagram showing the Zygoma Dental Implants added for posterior support in a patient with “egg shell bone”

The usual indication of the Zygoma Implant is when the patient has big sinuses with very low floors that cannot be grafted with sinus lift procedure. The same indication is for pterygoid implant.

Photo showing the zygomatic and pterygoid implant in patients with extreme atrrphy od the upper jaw bone. note that none of these implants require any bone grafting.

Photo showing the zygomatic and pterygoid implant in patients with extreme atrrphy od the upper jaw bone. note that none of these implants require any bone grafting.

If you have any questions about bone grafting, sinus lifts, dental implants or any other dental questions, please call my dental implants office in South Jersey, Sewell Dental Arts for a free consultation. I will be happy to meet you and help you.

Septimiu Pastiu DMD