Does A Patient Have Enough Bone?

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of the socket are very thin, such as in the upper and lower front teeth, this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help the body fill in the empty socket with bone. This step will maintain the width and volume of bone a patient will need for implant placement several months later.

An example of a jaw with inadequate front bone structure to support an implant
1. Inadequate Bone
A depiction of the placed bone grafting material to increase the bone structure
2. Graft Material Placed
A representation of dental implants placed after bone grafting
3. Implants Placed

There may be inadequate bone for implant placement if a patient’s tooth was removed many years ago and the bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to the patient’s pre-existing bone, the ridge will be re-entered and the implant will be placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including the patient’s own bone.

A jaw lacking enough bone in the back of the mouth for a dental implant
1. Inadequate Bone
An example of a dental implant after adding jaw structure with bone grafting
2. Graft Material and Implant Placed

Bone grafting may also be needed if the sinus cavities in the upper jaw are very large or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.

Case 1

Young female adult missing her front tooth with a large bone defect. Patient received a bone graft followed by a dental implant.

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