bone grafting Archives - Arnold Dental

Bone Grafting Did Not Work

Posted on February 17, 2024 by writeradmin.

I planned on letting my family dentist do my dental implant because he’s done hundreds of them even though he is not a specialist. He told me that I would need some bone grafting done. I went ahead and did that. After a time of healing, I was about to get the dental implant. When he went in he decided the graft was not ready and closed me up without giving me the dental implant. He told me I would need more grafting if I want the implant. I’ve had two surgeries and still no dental implant. I feel like this wouldn’t have happened if I went to a specialist to begin with. Do I need to give up on this implant or go to a different dentist?

Angela

Dear Angela,

Technically, there is not a recognized specialty in dental implants. However, some dentists have more experience than others. Though your dentist is likely very skilled at dental implants, he may be new at the bone grafting procedure. Don’t be too hard on him about that. There are two things I think are noteworthy about your dentist. The first is his willingness to broaden his skill set. There are still dentists who barely know dental implants at all. Your dentist is continually expanding his skills instead of just resting on what he knows. Adding bone grafting was the next step. Everyone starts off learning whenever they’re adding a skillset.

The second is integrity. To have to close up a patient and admit your procedure did not work took a lot of courage. There are many dentists who would have gone ahead and placed the implant rather than risk their patient losing confidence in them, even though the dental implant would fail down the line. You’d never know it was because of the bone grafting because it would not happen immediately. Your dentist was more invested in your procedure than saving himself embarrassment or money. That is a dentist worth keeping.

When it comes to a single tooth, both a dental bridge and a dental implant are great replacement options. If you still want the dental implant, you can get it, you’ll just need your dentist to recommend to you an oral surgeon with extensive experience in the dental implant procedure, including bone grafting. Just make sure it is your dentist who determines the placement of the implants and not the surgeon.

This blog is brought to you by Lexington Cosmetic Dentist Dr. Fred Arnold.

Will This Sinus Perforation Prevent Me From A Dental Implant?

Posted on July 12, 2023 by writeradmin.

I have some questions. I just had a dental implant removed. It was only placed six months ago. Unfortunately, my dentist suspected the bone wasn’t filling in correctly. During the implant surgery he did perforate the sinus cavity by several millimeters but said that it didn’t have any bearing on the implant and that sort of thing is fairly normal and happens all the time. After the removal he told me it was super easy to remove because there was no integration with the bone at all. He said to use Flonase and don’t blow my nose. The perforation was cleaned up but not repaired. He said it would heal on its own and once that happens we can start again.

I ended up with a pretty bad infection after that, which I eventually received antibiotics for. Should he have given them to me to begin with? And, will that prevent me from getting a dental implant after it is healed?

Mary

Dear Mary,

I am sorry this happened to you. The lack of antibiotics to begin with is okay as long as there was not any sign of infection. There are two bigger issues here. First, is the perforation of the sinus cavity. While it does sometimes happen, it is far from normal and does not happen all the time. Additionally, a few millimeters is huge in the dental field. It makes me wonder what type of diagnostics he did before your procedure. There should have been a series of x-rays including three dimensional ones, such as a CT scan.

A second issue is the lack of osseointegration, meaning the bone integrating with the dental implant. This is essential for any successful outcome. Before you allow this dentist to do anything else in regard to another dental implant, he needs to give you a good reason for the failure of the first one.

I am a bit concerned that your dentist does not have adequate skill and training when it comes to dental implants. This does require post-doctoral training and not every dentist invests in enough to really develop the skill they need for this.

None of what happened will prevent you from getting another dental implant, but you will need some bone grafting done first in order to ensure you have enough bone to retain the implant.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Will The Metal Show By My Gums If I Get Implant Crowns?

Posted on March 1, 2023 by writeradmin.

Last year I lost both of my upper front teeth playing hockey. Yes I know, I should’ve been wearing my guard, and believe me I’ll never forget it again! Right now I’m wearing a flipper to fill that space while I’m healing. I’m leaning toward getting implants there, but I’m kind of worried about how they’re going to look. It seems like the metal of the implant will show near the gum line, maybe? Does this happen?

Thanks,
Jared

Dear Jared,

First off, sorry about your accident! The flipper is a great way to go as a temporary solution. Though, obviously, you’ll want a long-term solution. The great news is you picked the right one! Dental implants are the best tooth replacement option around.

Bone And Healing

It’s good that you’ve had some time for the sockets to heal and the bone to fill in naturally. The longer it goes without anything there, however, you run the risk of bone atrophy, where it starts to shrink away. Generally, there needs to be a minimum of one millimeter of bone around a dental implant. More is needed in certain situations, such as if the implant is to be situated in proximity to another implant or a natural tooth. More is needed in many anterior (near the front) cases as well. Some cases require the grafting of bone where there is not enough. Your doctor will be able to tell you whether you are a candidate for implants there or not.

Will The Metal Show By My Gums?

If you are a candidate, you’ll be delighted to know that anterior implants are among the most beautiful ways to restore missing teeth. They will be designed to appear to emerge from the gingiva (gums) in a most natural manner: assuring they are properly placed and cared for, and there will be no metal showing at or around the gums.

Because it is an anterior tooth, however, you want to make certain the dentist has post-doctoral cosmetic dentistry training. This way you will have a beautiful, natural-looking result. Once you have narrowed down a few qualified dentists who place dental implants, then look at their cosmetic skills. The top-of-the-line cosmetic dentists are AACD accredited, so if you find someone with post-doctoral training in dental implants that is also AACD accredited, you will have hit the jackpot.

What if I don’t have enough bone?

It is possible that in the time you are in your dental flipper too much bone will be lost. The good news is that does not mean that you are not a candidate for dental implants. You will just need one additional procedure done beforehand. Bone grafting can build back up the bone necessary to properly secure an implant.

If you decide you do not want to go that route, then your next best option will be to get a dental bridge. This requires two dental crowns be placed on the adjacent teeth as an anchor for the false tooth that will be suspended between them.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Should My Dentist Pay for My Bone Grafting?

Posted on October 24, 2022 by writeradmin.

I had a tooth removed about ten years ago and went in to get a consultation about a dental implant. My dentist said that there is some bone loss in the area so I would need some bone grafting done first. I have since learned that the dentist could have done a procedure that would have preserved the bone. I was never offered that option. Should that dentist have to pay for this bone grafting procedure as it could have been prevented?

Mary

Dear Mary,

Dental implants are a fantastic tooth replacement, so you choose well. Bone loss happens when a tooth is lost or extracted, because your body recognizes the tooth is gone and wants to use your body’s resources as efficiently as possible. Most people lose about 60% of their bone within three years. After that, the loss continues at about 0.5% of the structure a year.

The procedure you’re referring to is referred to as “socket preservation” or “alveolar ridge preservation.” This procedure is a sort of bone grafting procedure. It is done by placing bone material in the open socket which over time helps bone develop there and make it more likely you can have a successful implant procedure later without needing further grafting.

There are only minimal studies on its effectiveness. The procedure was still emerging a decade or so ago. The cost of materials was pretty high and there was no real research on its longevity. As a result, not many dentists even offered it, especially if a patient wasn’t planning on a dental implant. Even today, when procedures have advanced, not every dentist uses it.

In this case, I would just go ahead and get the bone grafting done and then the dental implant. With the procedure being new at the time, he may not have even known it was possible.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Dentist Placed Implant Knowing it Would Fail

Posted on July 30, 2022 by writeradmin.

I went to get a dental implant and my dentist said I was a good candidate. Yet, after the surgery, he told me there was not enough bone structure. He placed the dental implant anyway knowing it would fail. He said after it does we can try again or if I don’t want that I can get a dental bridge. I’m really frustrated with this, especially since he billed me anyway. Is this common practice?

Drew

Dear Drew,

No, this is not common practice. Not only that, I have no idea how your dentist thinks he can get away with this. First, if he had done adequate diagnostics he would have known you did not have enough bone structure to support a dental implant. So, that is mistake number one. Next, he placed the dental implant knowing completely well that it would fail.

The basic standard of care is a belief that the procedure would succeed. He placed it knowing it would not. The first thing I would do is ask for a full refund. If he tries to give you a hard time about that, then I suggest you tell him that you would rather handle this privately but that you do understand the strength of your position and are willing to go to an attorney and the dental board if necessary. That should sober him up.

As for getting a dental implant. It is still possible for you to get one if you want. However, I would not recommend doing so through this dentist. You need to find a dentist with post-doctoral training in placing implants. In addition, because you do not have enough bone to sustain an implant at the moment, you will need to have a bone grafting procedure done to build the bone structure back up. I would not wait for your dental implant to fall out. Not only is this stressful for you, but it will be much easier to remove the implant sooner rather than later.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

I Can Smell My Husband’s Dental Implants

Posted on June 20, 2022 by writeradmin.

I have chemical sensitivities. My husband recently had dental implants placed in his lower jaw. His dentist used the metal type of implants. He has the temporary acrylic dentures fitted to them but will be soon having the permanent ones. I am thinking he needs to switch to the metal-free ones before the permanent dentures are placed because I am certain there is some type of chemical reaction going on in his mouth. His breath smells like rubber all the time and I have a hard time sleeping next to him as a result. This can’t be good for our health. His dentist thinks I’m being ridiculous but I’m thinking it has more to do with the fact that he doesn’t want to admit he should have used metal-free implants to begin with knowing my chemical sensitivity, which I made clear to him in the beginning. What can I say that will convince him he is wrong?

Tiffany

Dear Tiffany,

You mentioned his mouth smelled like rubber and it was causing you problems. Aside from the smell, are you having any reaction? Is he? Because titanium dental implants have been used for decades, we have a great deal of data on them. Titanium itself, though metal, is inert. This means it will not have a smell. I bet if you asked your husband’s dentist to allow you to smell one, he would. They are also extraordinarily biocompatible. While it is never wise to say no one has a reaction to them, it would be incredibly rare.

While I do not doubt there is an unpleasant odor, it probably has more to do with his dentures than his dental implants. The first thing I would look into is whether or not there is food and other bacteria getting trapped around or in his dentures. He may need to use something like a WaterPik to help him get everything out of there. This would be the safest and least invasive thing to try.

Why You Don’t Want to Remove Dental Implants Prematurely

If his dental implants are removed, they will take some bone structure with them. This means in order to get the zirconia implants you want him to get he will need some bone grafting done. After that has healed, he will have to have yet another surgery to place the new implants. That is three additional (and unecessary) surgeries. Plus, there is no guarantee that his second implant procedure will succeed.

I wouldn’t risk a successful case unless I had to.
This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Clear Choice or Costa Rica for Dental Implants?

Posted on January 31, 2022 by writeradmin.

I want to get some dental implants but my dentist said I have lost too much bone due to my gum disease for that to be a viable option. I’ve done some internet scouring and learned that people in my position often get the all-on-4 dental implant procedure at a place called Clear Choice Dental Implant Centers. I looked into them and they seem to get good results. My two concerns were the price seemed pretty high and there seems to be patients who said they felt abandoned after their procedure and there wasn’t really any follow up. It looks like I could go to Costa Rica for the same procedure but much cheaper. Do you have an opinion on which is my better option?

Angie L.

All-on-4 Dental Implants

I have a few thoughts on this. First, let’s talk about the gum disease. Make certain that is under control before undergoing ANY dental implant procedure. Otherwise, you are setting yourself up for failure. You will continue to lose bone structure as long as the gum disease is present which will lead to implant failure.

After that is dealt with, you have an option other than the all-on-4 procedure. You could still get traditional implant overdentures, which have benefits over all-on-4. The biggest issue is the safety net that if one implant fails with traditional implants, you just have to replace that implant. With all-on-4, however, the entire unit would have to be replaced. In order to get implant overdentures, you would need to build back up that lost bone structure with bone grafting. This will ensure you have enough bone to safely retain your implants. Then, after a period of healing, your implants can be placed and then your overdentures.

Where Should You Go for Your Dental Implants?

You’ve mentioned two places. The first is Clear Choice. Yes, their prices can be on the high side. That is because they are pricing their procedure to be about the same as what you’d pay getting bone grafting and implant overdentures, but they don’t have to do the bone grafting, which increases their profits. Another issue is they are a corporate practice, which has a list of downsides you can read at the link. Clear Choice tends to push the all-on-4 procedure on patients without giving them other options.

As for Costa Rica, if you think Clear Choice doesn’t have great patient follow-up, how much do you think you will get there? Will you be willing to travel back and forth for follow-up appointments if they do offer them? What about if something goes wrong, will you have recourse? How will you know if the dentists are qualified? There are countless dental implant horror stories both from unqualified dentists in the states as well as from dental tourism outside of the U.S. At least here you would have recourse.

My honest recommendation is you go to a private practice and let them examine you to give you all your options. Your dentist is steering you away from implants, which tells me he doesn’t feel comfortable placing them. Don’t push him into it. Instead, find a dentist with great post-doctoral implant training and get your work done there, where you will have personalized care and great follow-up.

This blog is brought to you by Lexington, KY Dentist Dr. Fred Arnold.

Should My Husband Get All-on-Four Dental Implants?

Posted on November 3, 2021 by Travis Wachendorf.

My husband is in need of dental implants. We went to see a dentist who said the option for us is all-on-four dental implants. It’s pretty pricey. I was wondering what cases would make it the only option? Should we seek a second opinion?

Katarina

Dear Katarina,

All-on-4 Dental Implants

I’m going to say right off the bat to get a second opinion. I am always leary of dentists who imply you only have one option. That is rarely the case. In fact, he is ethically bound to give you all of your options. I haven’t examined your husband, but I will tell you about some other possibilities that come to mind right away.

First, all-on-4 is designed to help people still get dental implants when they have bone loss by angling the implants a certain way. One of the problems with this method is that if one part of it fails, you cannot just replace that dental implant. The entire procedure has to be redone.

If your husband does have bone loss, another option is to have a bone grafting procedure done. Then, you can have implant overdentures, which may be the better option for him. If he doesn’t have any bone loss then both all-on-four and bone grafting are completely unnecessary and he can go straight to implant-supported dentures.

If cost is an issue there are other options as well such as snap-on dentures or mini implants. My point is, you are probably not limited by one procedure. There are lots of options here and I don’t like that he was not given any of them except one.

Look for an experienced implant dentist to get a second opinion. When you do that, make sure it is a blind second opinion. By that, I mean don’t tell him the recommendation your first dentist gave, nor the name of your first dentist. The dental world is a small world and they may be friends. If he asks, just tell him you’d like his unbiased opinion. He or she should not have a problem with that.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

Dental Implants Fell Off

Posted on October 4, 2021 by writeradmin.

I recently had six dental implants placed in preparation of implant overdentures. Since then, I’ve had four of them fall out. It’s only been a week. Here are my questions. First, should I be able to get a refund on the ones that fell out? Second, are the others safe if they’ve lasted this long? Three, can the ones that fell out be replaced?

Matthew

Dear Matthew,

Implant Overdentures

I don’t know who your dentist is, but you definitely need a new one. I cannot believe he hasn’t already offered you a refund. You should not even have to ask. You should not only have a refund on the ones that fell out, but all of them. That leads me to your second question. No, your dental implants are not safe. A week is hardly any time and given the fact that a majority of them have already fallen out, I would not hold out hope for these.

To put this in perspective. A decent dentist with experience in dental implants has a 97% success rate with dental implants. Those that do fail usually take over a year before anything like that happens. Instead of a 97% success rate, your dentist has a 33% success rate. That is completely unacceptable. I definitely want you to ask for a full refund.

Reasons for Dental Implant Failure

There are quite a few reasons why dental implants can fail. I don’t know which one of them was the reason yours did, but it will give you some possibilities. Then, we’ll go over what you can do to get sturdy tooth replacements.

Development of infection. One of the causes of this is having a dental implant that was improperly fitted. Generally, an infection is accompanied by pain and/or a fever. You did not mention either of these, so I don’t think this will be your issue, though it is always a possibility.
Diagnostic shortcuts. Before your procedure, your dentist should have done a number of diagnostics, including x-rays and a CT scan. This is, in part to make sure you have enough bone structure to retain your dental implants.
Incorrect placement of the fixtures. Some dentists try to up their profits by ordering their dental implant parts outside of the United States. While they will be several hundred dollars cheaper, they are not made to the same specifications we require in order to protect patients.
Improper placement of the implants. If a dentist places the implant incorrectly, it has a high likelihood of failure.
Premature loading. Before your dentist places either a dental crown or a complete denture on the implants, there needs to be enough time for the bone to integrate with it. If a dentist does this too soon, it places too much weight and pressure on the implant, which will cause it to come loose and fail.

The first thing I want you to do is see a skilled implant dentist for an evaluation of these implants. He or she may be able to tell you why they are failing. Additionally, I would ask for the full refund. You shouldn’t have much problem receiving that. After all, a basic expectation of dental work is that it will stay in.

To answer your final question, yes, these can be replaced. I don’t want you to just replace the ones that have fallen out already, but all of them. Be aware that you will need one additional procedure before moving forward. In order to retain your implants, your body will need enough bone. When implants fail, they leave a hole in that bone structure. Because of that, you will need some bone grafting done. This will replace the missing bone and give you the structure you need to keep your next set of dental implants in place. Then, you will finally be able to complete your implant overdentures and have a secure bite and smile.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

Getting a Beautiful Smile After Dentures

Posted on July 26, 2021 by Travis Wachendorf.

I have had dentures for twenty years and have never liked my smile. I have the money for dental implants now and wondered if it is too late for me to get a beautiful smile with dental implants? I’m finding it difficult to keep my dentures in these days, so this seems like a good time to switch.

Margie

Dear Margie,

Implant Overdentures

I have great news for you. It is never too late to have a beautiful smile. The key is choosing the dentist who does your dental implants carefully. You want someone who not only has extensive post-doctoral training in placing dental implants but is also a skilled cosmetic dentist. The cosmetic skill of the dentist matters much more than which procedure you get when it comes to how beautiful the results will be. For example, even your dentures could have looked beautiful and natural if the dentist who did them had invested in cosmetic dentistry training. The best cosmetic dentists are AACD accredited dentists. They will give you a stunning smile.

One other thing to be aware of is the length of time you have been in dentures. From the moment your teeth were removed, your body recognized that you no longer had any teeth there and immediately began to resorb the minerals in your jawbone in order to use them elsewhere in your body where it feels they will be most useful. While a remarkably efficient way to utilize your body’s resources, it also has the unfortunate side effect of shrinking your jawbone. After somewhere between ten and twenty years, your jaw will become so shrunken that you won’t be able to adequately keep them in, as you are currently experiencing yourself. This is known as facial collapse. Without that bone support, your jaw will not be able to retain your dental implants.

The good news is that there is a solution. You can have bone grafting done. This is an outpatient procedure which will build back up the lost bone. Once that is healed, you will be able to have your implants placed. When you are replacing a complete arch, it is standard (and much more affordable) to place implant overdentures. It would be cost-prohibitive to do a crown per tooth.

Aside from the security of implants, there are two other huge benefits. First, your quality of life will go up dramatically. One of the first things you may notice is your chewing capacity will increase. Even the best fitting dentures reduce your chewing capacity by 50%. Now, you’ll be able to eat whatever you want. The best benefit (at least in my opinion) is that you will no longer have to worry about facial collapse.

This blog is brought to you by Lexington, Ky Dentist Dr. Fred Arnold.