Dental Implant Facts and Science

Bone Grafting for Dental Implants

Do I have enough bone for dental implants?

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 your socket are very thin (such as in your 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 your body fill in the empty socket with bone. This step will maintain the width and volume of bone you 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 dental implant placement if your tooth was removed many years ago and your 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 your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. When rebuilding this lost bone – Dr. Loetscher firmly believes it should be replaced by bone from your own body. This maintains the success rate of your dental implants in the 98% and higher. The source of this bone may be your jawbone, your hip, and nowadays – tissue re-engineered bone utilized growth factors that turn on your own stem cells. The growth factors eliminate using your 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

You may also need bone grafting if the sinus cavities in your 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 lift grafting procedure” is then required. This is a very straightforward and successful procedure, well tolerated. 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 dental implant placement.

Dental Implants FAQ

Why Dental Implants?

There are several reasons. In dentistry — implants provide by far the highest success rate of any treatment modality we offer. For one — it avoids sacrificing and cutting down perfectly good teeth to bridge a gap. For single teeth — they replace a missing tooth or broken tooth and can become a perfect functional and esthetic solution. The implant crown may become one of the strongest teeth in your mouth and often you may forget which tooth is an implant. In addition, removing a denture or partial at night may be inconvenient, not to mention that dentures can slip, and be uncomfortable and rather embarrassing.

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Why do you take 3D scans before implant placement?

3D scans are a diagnostic tool used for several things.

  • First — they allow us to determine the quality and quantity of bone in and around your teeth. This tells us whether or not we can place an implant at the time of extraction.
  • Second — it helps us to determine what size of dental implant to use — to avoid anatomic structures such as nerves.
  • Third — it may help in our decision whether or not to bone graft the area around your implant, or to bone graft an extraction site.
  • Fourth — they help us determine which areas are best to place implants.
  • Fifth — we combine them with software from intra-oral scans to fabricate surgical guides for accurate guided implant surgery. They are also useful in assessing other things in your jawbones and teeth — such as cysts, neoplasms and cavities.

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How much does a dental implant cost?

There are two costs in replacing a tooth with an implant. The cost for the implant, and the cost for the tooth that goes on it. Fees vary quite a bit for placing an implant — because the situation can vary significantly. However the fee for a single implant typically is in the range of $2500-3000. This can go up if bone grafts and other services are needed. The skill of the surgeon is a factor, as are other things, such as name brand vs. generic implants, having the procedure carried out under a “Sterile Technique”, and the use of surgical guides. It often goes down when many dental implants are being placed — with global fee structures. Dr. Loetscher provides high value due to the fact he uses name brand implants, they are placed by a skilled surgical team, under sterile technique. Surgical guides are used to provide accurate placement — which is important for esthetics, function and a cleansable implant.

The other fee is the cost to place the crown on the dental implant. A typical fee range from $2200-to-3500 as well. These can vary as well depending upon the skill of the dentist, and demographics to some extent. They can also go up or down depending upon the quality and esthetics of the material the final crown is made of, or if many teeth are being done at once.

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What is the recovery time for dental implant surgery?

Very quick if it is a straightforward procedure — such as an extraction with implant placement, or implant placement. Mostly patients are fine to go to work the next day.

When bone grafting is done — the recovery can vary quite a bit. Many bone grafts are simple and you are basically fine the next day. With some extensive reconstructions — where bone is removed from your jaw, hip or reconstructed with tissue engineering you may need 3-7 days to get back into the swing of things. In general — it is very quick.

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Can you place a dental implant on the same day I come in for the tooth extraction surgery?

Yes, this is very common. Dr. Loetscher does this almost daily, and hundreds of times a year.

For most teeth except molars this is a normal protocol. Dr. Loetscher has also developed a protocol that allows us to fabricate a temporary tooth on the implant the day the tooth is removed. This not only avoids a second procedure, but provides a highly esthetic and functional solution to the missing tooth — eliminating the need for a removable dental prosthesis.

With molars where the roots leave 2-3 holes behind — we often bone graft the site, and place an implant 3-6 months later. However — there are some successful techniques to graft molar site as well the same day they are removed — in the right situation.

One time we cannot place an implant on the day we remove the tooth is when there is an active infection around the tooth. In those situations we often remove the tooth, let the infection clear up and then place the implant. These situations also may require additional bone grafting.

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Can you get on a plane after dental implant surgery?

In most cases you can fly that day or the next day. The exception is when significant bone grafting was done, causing swelling or discomfort. When you have your whole mouth rebuilt in one day — it typically is wise to wait a day or two to travel extensively or fly.

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When can you brush or use a water pick after dental implant surgery?

In most cases you can brush and floss in the surgical area the next day. You can brush your other teeth immediately. We recommend not using water picks for approximately a week so they do not open up the wounds from the water pressure.

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Will you extract a tooth under local anesthesia?

Teeth can be extracted under local anesthesia. However — it is the least common technique for tooth extractions and implant placement. The majority of patients have tooth extractions done under IV sedation or general anesthesia. This allows for appropriate patient comfort, and higher surgical proficiency and technical skill. The exception is baby teeth and teeth being removed to gain orthodontic spacing. Many teeth being removed and replaced with an implant have a problem associated with them — such as infections, abscesses, or they are severely broken down. It is typically in the patient’s best interest to have supplemental IV anesthesia so they are comfortable, and the teeth can be removed skillfully, preserving bone, etc. Dr. Loetscher is board certified in anesthesia as well as oral surgery, and can offer the patient the option that best fits them.