Dental Implants

Extraction and Socket Grafting

: Dental Implants

When a tooth is removed, the ridge loses shape and volume. If implants are being considered, socket grafting is done to prevent the loss of dimension of the ridge. Many times, an immediate implant can be placed in the socket. However, if an implant is not feasible, socket grafting will preserve the contours so that an implant can be placed later. Our office uses atraumatic extraction techniques that preserve the bone so that your future implant will have a solid foundation.

Step 1: The tooth is extracted

Step 2: There is a bone defect present

Step 3: Bone grafting is placed into the socket

Step 4: A membrane is used to cover the graft material

Step 5: The area is sutured and allowed to heal for 3-6 months

Sinus Augmentation

: Dental Implants

In your upper jaw, the premolar and molar teeth are often in proximity to your sinus cavity, which is an air-filled space that helps to clean out mucous and filter the air you breath. After teeth are extracted, the sinus floor may be close to the crest of bone. Since an implant cannot be placed into this empty sinus cavity, augmentation is needed to add bone to the sinus floor and allow for proper implant placement. The sinus procedure is very predictable when performed by an experience surgeon, and success rates for sinus-grafted implants are similar to normal implants. Healing takes between 6-9 months to allow the grafted bone to become dense and mature like your native bone.

After tooth was extracted, the sinus floor was very close to the crest of bone, leaving no room for the implant.

After sinus augmentation and healing for 6 months, the grafted bone was mature and enough volume for an implant

Implant Placed in Ideal Location

Bone Grafting for Implants

: Dental Implants

After teeth are extracted, the bone that previously supported the teeth will be lost. The amount of loss can be from 25% to 50% of previous volume, and this loss can be in height or width. The consequence of this can be both esthetic and functional. The goal of bone grafting is restore much of the lost volume so that implants can be properly placed. Implants placed in an ideal location in grafted bone are as successful to those placed in native bone.

Recent developments in materials allow for donor bone from a cadaver or bovine bone from a cow to be used for grafting, sometimes along with some of your own bone. Sterilization of bone graft virtually eliminates the risk of graft rejection. These techniques allow us to use less of your own bone and still achieve preditable outcomes. We utilize various membranes to allow us to shape the bone in the desired form for ideal implant placement. Bone grafts take time to heal, usually 6-9 months, and your periodontist will discuss what to expect from the outcome.

Initially, there is a large volume of bone missing after teeth were extracted and not replaced

After grafting and healing for 9 months, the ridge is restored to proper shape and contour

Implants are then placed in the ideal position for long-term success

Immediate Implants

: Dental Implants

Sometimes when a tooth fractures, or periodontal disease or cavities become too severe, a tooth may not be able to be saved. It is often preferable to replace the tooth immediately with an implant. Immediate implants are as predictable as standard implants, and can be performed by experienced surgeon in many cases. It will often require 3D imaging and may require bone grafting and soft tissue grafting to achieve an excellent result. Your periodontists will discuss with you whether an immediate implant is possible in your case. After implantation, it will need around 3 months to heal prior to placing an abutment and crown. If an implant cannot be placed, socket grafting will be performed (see section on extraction and socket grafting).

Before – A failed bridge left teeth broken to the gumline

After Immediate Implants, bone graft and soft tissue graft – the full contour of the ridge is repaired, and restored with a new porcelain bridge

Overview of Dental Implants

: Dental Implants

Missing teeth can cause problems with speech, appearance, and shifting of the teeth may occur, causing problems with function. Options for replacing missing teeth are bridges, partial dentures, and since the 1980’s, dental implants. Dental implants are often a preferred option because they simulate a natural tooth and do not require alteration of the adjacent teeth.

After proper diagnosis and planning, dental implants can be a very predictable treatment option to replace missing teeth. Often, a 3D image is taken to plan and look at the anatomy of the site. They require an experienced surgeon to place properly, and then a skilled general dentist to make the restoration. They are made of titanium, which integrates to your existing bone over a period of around 3 months. After this, an abutment and crown can be placed on the implant (see below).

Dental implants require a review of your medical and dental status. Smoking, diabetes, periodontal disease and osteoporosis are some risk factors that may interfere with implant integration and health. Your periodontist may recommend medical consultation or controlling periodontal disease prior to receiving your implants. Our goal as periodontists is to place implants that will last you a lifetime.

After placement and the crown, we will recommend a cleaning schedule to ensure that your implant stays healthy.

Your periodontist will discuss whether implants are right for you. In certain cases, bone grafting or soft tissue grafting may be necessary (see other sections). Our goal is to give you the most predictable treatment and an excellent, long-lasting results