Considering Bone Structure Before An Implant

Many implant patients are faced with needing extensive bone augmentation prior to their implant procedures. The need for bone augmentation also prolongs the time before the implant can be inserted, since it takes time for new bone to adhere to the jaw. As director of the Dentaprime Clinic, Dr. Regina Schindjalova has several years’ experience in the implantology and bone augmentation field.

Interviewer: Dr. Schindjalova, you’ve looked after thousands of implant patients since the Dentaprime Clinic was first opened. How many of them have needed bone augmentation?

Dr. Schindjalova: In my experience, around 90% of the patients who come in for one or more implants require bone augmentation first.

Interviewer: Why is bone augmentation carried out?

Dr. Schindjalova: Implants must be of a particular length in order for them to be securely anchored in the jaw. In turn, the jaw must at least be thick enough to accommodate the implant comfortably. If the jaw is too thin, the implant will protrude and will not have the opportunity to grow into the jawbone properly.

Interviewer: Why might the bone be too thin?

Dr. Schindjalova: For various reasons. Number one, the jawbone might always have been naturally thin. Alternatively, a lack of mechanical pressure in a certain location can trigger bone resorption; other contributing factors include periodontitis or long-term edentulism (that is, the absence of some or all teeth). A single missing tooth is all it takes for the bone to start receding.

Interviewer: What happens during bone augmentation?

Dr. Schindjalova:   That depends on the exact procedure and method. In general, all procedures aimed at thickening the bone involve filling empty space with bone or bone substitute material. Let’s take the sinus lift as an example – in this method, the maxillary sinus membrane is lifted above the upper jaw and the resulting space is filled with bone material.

Interviewer: Where does the bone material come from?

Dr. Schindjalova: One option is to use bone substitute material – we work with Bio-Oss from German firm Geistlich, a bio-material that promotes bone formation and healing. Another option is to work with material taken from the body itself. For minor bone augmentation procedures, we can use bone chips harvested from other procedures on the jaw or from bone-rich regions of the lower jaw.

Interviewer: What materials do you like to use?

Dr. Schindjalova: We prefer to work with bone substitute materials – although this doesn’t mean refraining from the use of natural bone completely. Bone substitute materials are combined with endogenous cells and introduced to the desired area, where they form a matrix. New bone then forms naturally along this matrix.

Interviewer: How long must the patient wait for their implants afterwards?

Dr. Schindjalova: If there are only one or two teeth to be restored, we can insert the implants on the same day. For more extensive restorations, the material and the bone augmentation require between 6 and 9 months.

Interviewer: What advice would you give an implant patient with regards to bone augmentation?

Dr. Schindjalova: Patients should seek individual guidance and agree with their implantologist on the best course of action. They should also make sure that the specialist has experience in this area. Experience is everything when it comes to dental medicine.

Have questions on the topic of bone augmentation, or an experience you’d like to share with us? Leave a message for us in the comments – we’ll be happy to get back to you!