Can you get dental implants with severe bone loss?
Wondering if you can get dental implants with bone loss? Explore our comprehensive guide to understand your options.
Dental implant restorations offer strength, stability, and aesthetic improvements when replacing missing teeth; they’re designed to last a lifetime with proper care and maintenance. However, if you have jawbone loss from gum disease (especially if it’s severe), you may wonder if dental implant treatment is still an option for you.
The good news is that although your procedure timeline may be longer, advancements in technology and techniques have made it viable to treat patients with severe bone loss. At ClearChoice Dental Implant Centers, we have extensive experience with complex cases and jaws with resorbed bone. Let’s explore dental implants with severe bone loss in more detail to understand your options.
How dental implants work
Dental implants are small titanium posts surgically placed in the jawbone. They replace missing teeth by acting as durable artificial tooth roots. When the post is placed, it fuses to the jawbone over 2 to 4 months via a process called osseointegration. Once the implant is osseointegrated or healed to the bone, the dentist places a connector piece called an abutment, which allows them to restore the missing tooth, teeth or a full arch of teeth. They then take impressions and have you return for one more visit to receive the official crown. This process restores your tooth’s look, feel, and function. It also helps preserve your jawbone and guard against other complications.
Can I still get implants if I have severe bone loss?
Thanks to technological advancements, most patients with severe bone loss can still get dental implant treatment. Consult with your ClearChoice team of specialists to better understand your situation and determine whether implants are the right option for your needs.
How to get dental implants with severe bone loss
Patients with severe bone loss may qualify for dental implants through the following methods:
Bone grafting and alternative implant sites beyond the upper jawbone
Bone grafting uses bone material from another source to strengthen the target bone, in this case, the jawbone. Bone graft from humans and animal donors are prepared in specially licensed and certified bone centers. Four main types of bone grafting materials exist:
Autograft: Uses bone material from another bone in your body, such as your hip or chin.
Allograft: Uses bone material from a deceased donor.
Xenograft: Uses bone from an animal, such as a cow or pig.
Synthetic bone graft: Uses artificial materials that mimic bone.
The bone material slowly integrates with the native jawbone, offering additional strength to support implants.
Zygomatic implants
Some patients have very large sinus cavities within the upper jaw. The sinus cavities along with the upper jawbone loss sometimes requires that the surgeon examine placement of implants in bone located beyond the upper jaw. Zygomatic implants may be used in patients who need upper jaw implants yet have severe upper jawbone loss. The surgeon inserts one end of the implant into the zygomatic bone - the cheekbone - and the other end is within the jawbone. These implants are very long in length to span the distance from cheekbone to the jaw. This implant placement alleviates concerns of minimal bone volume in the jaw. Zygomatic implants are more costly and complex and may require more surgical recovery time than regular implants. They require special surgical expertise. They offer another option for upper implants and can avoid or greatly decrease the volume of bone grafting needed. Choosing the zygomatic option over sinus grafting will not increase the treatment time from surgery to final teeth.
Pterygoid implants
Another option for implant placement to restore the upper jaw, is use of the pterygoid process, a dense bone structure in the very posterior of the upper jaw. This bone is not part of the upper jawbone but is so close in proximity that implants placed here can be in alignment and attached to other upper implants. Pterygoid implants are usually longer than traditional implants and require special expertise in placement. Pterygoid implants can reduce or eliminate the need for bone grafting, thereby speeding up the time from initial surgery to delivery of final teeth.
Subperiosteal implants
For individuals with a weak or insufficient jawbone, subperiosteal implants offer an alternative solution. Instead of being placed within the jawbone, these implants cover a very broad surface area of the existing bones of the mid face and lower jaw and rest on top of the bone with projections extending through the gum tissue where the dental prosthesis is attached. This option has not been mainstream for a number of years, because the osseointegrated implant came into existence. However, revisions to the design of this type of broad implant structure and the use of the computer and 3-D imaging and special cad-cam milling machines, a much improved version is being made by very few companies. This option may be considered when the bone loss of the jaws is very severe.
Benefits of bone grafting
Here are some advantages that bone grafts offer dental implant patients:
Gain bone volume in the jaw: A certain width and height of bone is necessary to completely cover an implant and allow it to integrate to the bone. Getting the correct dimensions of bone can be accomplished by usually placing bone graft along the edges of the existing jawbone and allowing the native bone and bone graft to grow together. This creates a larger bone to accept the implant.
Preserves sinus integrity: Often the sinus cavities are large and encroach into the jaw where an implant is required. Bone graft material can be placed in the sinus cavities and allowed to become dense living bone that can accept an implant several months later.
Reduces further bone loss: Restoring the bone with an implant stimulates bone growth and reduces the risk of further bone loss.
Here are some requirements and considerations to determine if you are a good candidate for bone grafts:
Need for bone graft: Remaining bone volume is too narrow or too short to allow placement of an implant of adequate size to support teeth.
Good overall health: This is crucial for increasing the chance of bone graft healing. Candidates should ideally be free of underlying conditions that may impair healing.
Dental infections in the bone: An abscessed tooth often creates a defect in the bone that will not allow implant placement in that site. The infection and tooth must be removed and a bone graft placed so that an implant can be placed in that site later.
Nonsmoker or willing to quit: Smoking can impede healing by restricting blood flow and can increase the risk of the graft failing.
Willing to wait longer: Bone grafts extend the procedure timeline due to the need for healing and jawbone regrowth.
Benefits of zygomatic implants
Zygomatic implants offer several benefits that could suit certain patients.
Does not require bone grafting at the implant site: Zygomatic implants use the cheekbones instead, helping you avoid an additional procedure.
Strength: The cheekbone is often quite strong, offering sufficient implant support, although some people have very small dimensions to the zygoma precluding use of the zygomatic implant.
High success rate: Zygomatic implants can offer a high success rate for more severe bone loss in the upper jaw.
A patient may be a good candidate for zygomatic implants under various conditions:
Nonsmoker or willing to quit: Like other implant procedures, smoking can slow healing by restricting blood flow and can increase the risk of failure.
Good overall health: Given the increased complexity, patients should be healthy without underlying conditions that could slow healing.
Needs a full upper jaw restoration: Zygomatic implants can replace a full arch, typically with four implants provided the zygoma bones are large in dimension.
Dislikes upper dentures: Patients who don’t like upper dentures for discomfort or maintenance reasons may be good candidates for zygomatic implants.
Advantages of pterygoid implants
Do not require bone grafting at the implant site
Avoids sinus bone grafting: When upper bone loss exists and the sinus cavities are large, there is no bone available to place implants in the molar area of the fixed full arch implant treatment. The pterygoid implant can be placed further back in the mouth, to become the most posterior implant of the fixed full arch restoration. The pterygoid implant can eliminate the need to bone graft the sinuses.
Enhanced prosthesis support: It adds an additional area for implant placement on the fixed full arch, when the upper jawbone has had bone loss.
Immediate attachment of the implants on surgery day: The pterygoid bone tends to be quite dense similar to the zygoma bone. Pterygoid implants can be attached to a fixed prosthesis on surgery day due to the dense bone.
Shortened treatment time: Choosing pterygoid implants over the option of sinus grafting, there is no increase in treatment time from initial surgery to final teeth.
Advantages of subperiosteal implants
No bone grafting required at the implant site: No bone grafts required because of the unique placement.
Custom-made: Subperiosteal implants are custom-made to fit the contour of the jawbone and provide support for the replacement teeth.
Modern imaging: While subperiosteal implants have been used in the past to less success, modern imaging and techniques allow them to fit much more precisely and work for a very resorbed jaw
Reduced treatment time: Because no bone graft is needed, this reduces the overall time required from initial surgery to final teeth.
Consult with a ClearChoice doctor to find out if you are candidate for dental implants
Thanks to bone grafts, pterygoid implants, and zygomatic implants, many patients who aren’t sure about their dental implant candidacy may qualify for this amazing procedure. That said, each patient has a unique situation, and your best bet is to see a specialist. 98% of ClearChoice Dental Implant Centers consults are candidates for dental implant treatment. Visit a ClearChoice Dental Implant Center near you to explore your options and learn more.
Dental implants with bone loss FAQs
How long do bone grafts last for dental implants?
Bone grafts for dental implants last for life since your natural jawbone integrates them by growing more jawbone around them. However, good oral hygiene is key because it lessens the risk of further tooth loss that could weaken the jawbone. Brush, floss, rinse, and avoid smoking to keep your teeth and jawbone healthy.
How much is too much bone loss for dental implants?
While there’s no specific point where bone loss is “too much” for implant treatment entirely, too severe of bone loss may warrant alternatives to standard implants. For instance, bone grafts may work well for patients with the time and ability to heal from an additional procedure. Meanwhile, zygomatic implants can help patients with weak upper jawbones get implants without a bone graft.
Is bone grafting for dental implants worth it?
Bone grafts for dental implants are often worth it since the implant ultimately restores the natural tooth’s look, feel, and function. Growing enough bone volume to support the implant, that will ultimately support the prosthesis, that will ultimately support your face and lips, is what makes bone grafting worth it. Discuss options with your ClearChoice team to determine your need for bone grafting or special implants and consider your tolerance for procedure length and invasiveness.
What is the success rate of zygomatic implants?
Zygomatic implants typically have a high success rate. This is partially because they anchor to the strong zygomatic bone. Following post-care instructions and maintaining good oral health is key to long-term success.