Why Regenerate Bone for Dental Implants Versus "Graftless Solutions"
Posted on 4/21/2021 by Greg Kammeyer
Some dental practitioners provide dental implants without bone regeneration, and promote a Graftless approach. I will review why I often need to graft bone before or during dental implant placement, and how this compares to the graftless approach that some advocate.
Dental implants require more bone for long term stability than teeth do. When teeth are lost and no bone is regenerated in the socket, the bone shrinks 25% in 3 months and 50+% within 6 months. Typically when a tooth is to be removed it additionally has some bone loss due to periodontal disease. When the area was not grafted, I would see exposed implant parts or the implant would be exposed within a few years of placement.
When the metal under porcelain crown is exposed, the exposed implant gathers plaque easily. This combined bone recession, gum recession and inflamed tissue require a much more extensive and invasive solution to fix the gingival recession.
Research has shown that 2/3rd’s of gum tissues and bone are thin and need to be thickened before an implant gum line and bone are stable. Research also shows that the bone around an implant must be thicker for long term stability than is necessary for a tooth.
When a significant loss of bone is evident, it is necessary to regenerate the bone prior to the implant placement. This is most common with upper back teeth since the sinus’s get larger as we age, leaving less bone for dental implant placement. When infected teeth have significant bone loss or the teeth have been missing for a long period of time. Again that lack of bone will cause further problems for patients if they are not addressed early in the treatment sequence.
From what I understand, often dentists mean Graft Less rather than a no graft approach. If less is adequate and stable, I favor that. Otherwise, I believe with the time, money and energy that dental implants take, doing the treatment well is necessary for long term satisfaction.
Dr Kammeyer received his dental implant training in a 3 year residency at Loma Linda University, as well as a Master’s degree in bone regeneration. He is Board Certified and limits his practice in Sun City West Arizona to Dental Implant Surgery. He can be reached at Solutions Dental Implants: 623-556-5442.
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