What is Peri-implantitis and What Do I Do About It? – Bone Loss Around Dental Implants ~Burbank Dentist, Ramsey Amin Reviews

One of the long-term risks associated with dental implants is a condition called Peri-implantitis.

Peri-implantitis Definition: Infectious disease that causes inflammation of the surrounding gum and bone of an already integrated dental implant, leading to the loss of supporting bone.

These two x-rays show implants with bone loss.Peri Implantitis review ramsey amin dds bone loss implant ramsey amin dds burbank

Bone Loss Around Dental Implants

Bone, for a variety of reasons, is lost around the dental implant.  This condition generally occurs without the patient being aware of it. There are many factors on why this can happen.  Some dental implants on some patients will develop bone loss which can happen very early after having the crown put on the implant or it can happen many years down the road. Dental implants are fantastic, but nothing is without risks. If your dentist tells you they are 100% successful and have no problems ever, I would suggest seeking another opinion.

This condition is difficult to treat. Fortunately, most patients never develop this.

Most patients are unaware that they have bone loss around the dental implant. Peri-implantitis generally progresses in a painless fashion. Once it is established, you may begin to develop symptoms.

There are several risk factors. Smoking definitely causes constriction of blood vessels which leads to bone loss. Medical issues such as diabetes, osteoporosis and poor immune systems are more at risk for developing bone loss around dental implants. If you have had gum disease in the past, you are more at risk. Your home care is critical… Brushing twice a day for 3 to 5 minutes with an electric toothbrush, flossing once a day and using adjuncts such as a rubber tip need to happen every single day… Forever!!  Grinding your teeth is another risk factor for dental implant bone loss.

Of course there are surgical factors that cause peri-implantitis to happen:

Soft bone, lack of tightness when the dental implant is placed, bone that was grafted in a vertical fashion, implant size too big, overheated bone, and many others.

 Signs of peri-implantitis

  • gum pockets deepen
  • pus comes out from the implants and gums
  • bleeding at the gumline
  • appearance – gum is red, or slightly purplish bluish, tartar/plaque build up
  • progressive loss of supporting bone on x-rays
  • metal thread exposure
  • long tooth

It is not always symptomatic and typically there is no pain. Some of my patients have complained of dull aches or tenderness when they brush or touch the area. You can also develop a bad taste if pus has developed. If it is very severe, the glands in your neck may become swollen and you may even feel the dental implants being loose.

Who Should Correct Your Dental Implants?

I treat many patients with this problem.  Unfortunately many of these patients had implants done with inexperienced dentists or large supercenter practices. Correction of dental implants with problems should be performed by a dentist who routinely performs this procedure.

The first thing I check for is to make sure the crown or bridge was made properly. The x-ray tells so much. Sometimes a 3-D scanning is necessary to see the inside surface. Extra cement is often the cause of peri-implantitis. The cement oozes beyond the abutment and gets down below the gum near the bone. The cement becomes an irritant. There is often good reason to make crowns held in by screws rather than cement in some cases. The technique of cementation and choice of cement used is a big factor on whether or not this will become an issue for you.  You would be surprised to know that most novice dental implant dentists are not aware of proper cement choices although they have no ill intentions just lack experience and knowledge.

Occasionally I will find a loose abutment screw which may not have been torqued properly or it broke. That can be caused by someone with a really heavy bite. Patients with heavy bites need to have their crowns designed to protect the implants. How the crown is made is ultra critical for the longevity of the dental implant in the bone. So many patients view this step as minor, but it is major. Some low-budget implants have poorly designed screws or have micro motion when you chew.

Sometimes we find gum disease on other teeth just nearby which can stimulate peri-implantitis to start on the implant. Generally some type of exploratory surgery needs to be done to find out the cause and do a simultaneous bone graft in an attempt to save the implant. Not all implants that have peri-implantitis can be saved.

Normal Implant Bone x-ray (Implant by Dr. Ramsey Amin Burbank, California)X52609

Treatment

The long-term goals are to stop the progression of bone loss and maintain your dental implants! Generally speaking the area will need to be cleaned thoroughly using dental instruments. Oftentimes antibiotics will be prescribed and special antibacterials will be applied to the implants itself such as iodine or tetracycline.

Most peri-implantitis dental implants require surgery and bone grafting. This means that your gums have to be opened and the area has to be detoxified. All of the bacteria must be killed in order to have bone regrafted onto the implants. I will definitely place you on antibiotic after this procedure.

The physiology and the type of bone that is used is critical. I would also suggest using your body’s own helpful blood products such as PRF/ PRP.

Time will tell if the procedure works. There are no guarantees on grafting around implants that have pre-existing bone loss. It is far more successful if the bone missing is in the shape of a moat rather than an entire wall missing.

Over the last 14 years of placing implants, I have developed many techniques to avoid this from occurring. When it does occur I have also developed techniques that seem to be more predictable. I have successfully regenerated bone around many implants over the last 14 years in practice. We have to be realistic when an implant has had too much bone loss though. The success rate can be as low as 35 to 50%. Some severe cases of peri-implantitis are better off removing the implant and placing a new one.

Just because one implant may have failed or develop bone loss, it doesn’t mean the second one will.

Please feel free to comment or ask questions below that are relevant to this post.

Floss!

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry


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56 thoughts on “What is Peri-implantitis and What Do I Do About It? – Bone Loss Around Dental Implants ~Burbank Dentist, Ramsey Amin Reviews

  1. Tiffany colgin

    If this is happening could it be the fault of the dentist I had implants put in and on the bottom a hole or space was left open and this is the area where I’m having reoccurring infections should I go to the dental office that did the procedure?

    Reply
    1. RamseyAminDDS Post author

      Peri-implantitis happens for so many reasons. There are times that it does occur due to poor implant position but it is so multifactorial it is hard to pin it down often. medical issues, bone anatomy, implant design, oral bacteria, and bite force, smoking, tissue thickness and about 100 other things all contribute

      the link above talks about how to bone graft some of these cases. Good luck!

      Reply
  2. ray

    Thank you for this post it was extremely helpful. I am a 21 year old student who had an implant placed about a year ago i noticed some inflammation the last few weeks and went back to the dentist last week for him to tell me he was very concerned and I have lost a lot of bone due to plaque buildup? I explained that I brushed my teeth twice daily and that after having worn my retainer at night the inflammation got worse. He implied that not brushing my teeth was the cause as it ‘had to come from somewhere.’ I was quite disgusted as I take pride in looking at my teeth Im very upset and now looking at meeting with a gum specialist and have a second surgery as a student I dont know how I am suppose to afford all this? Is it worth getting a second opinion or do I have any other options?

    Reply
  3. LCK

    I had an implant done on tooth #2, developed peri-implantitis and had surgery with bone grafting about a year to a year and a half later in September of 2016 Now I have it again and my periodontist recommended doing a second surgery. I’m a little hesitant since it did not work the first time but I also don’t want to lose the implant. Do you think it’s worthwhile to do the surgery a second time?

    Reply
    1. RamseyAminDDS Post author

      IF the prognosis is good then I would suggest doing. If this is a shot from half court, you may want to start over again

      Reply
  4. Linda Grant

    Hi I have had excessive saliva in my mouth like gunge, I had a full lower bridge implant March 2015, I went for check up two weeks ago and was told everything was fine, no X-rays were taken even though I said I had a funny taste in my mouth. I am very concerned as paid £12,000 + for my treatment.

    Can you advise please

    Thank you

    Linda Grant

    Reply
      1. Linda

        Thank you for your reply, I can’t get appointment till Wednesday and there is a horrible thick gooey stuff in my mouth, I think it’s coming from my gums, it’s making me feel sick and high temperature, is this poisoning my system? I am am so afraid as it’s only Monday.

        I have taken some antibiotics in the meantime.

        Linda

        Reply
  5. PFS

    I had 5 implants placed in the mandible all in the chin area due to not enough bone in the jaw. The original treatment plan was 4 implants but in this case a 5th implant was placed. 3 months later the surgeon checked the implants to see how they had integrated. They were fine but one had threads showing and the surgeon said that he could see plaque on the threads under the gum tissue. He said that bone loss was present (that is why the threads were showing) and would progress. The bone loss seems to be toward the back on the tongue side or perhaps between the implant on the one next to it. It’s hard to see because I’m wearing a temporary fixed prosthesis. (I had pain and a lot of issues in this area from the very beginning) He told me the reason this happened is that I did not keep the area clean enough. I doubt this is the reason, at least not 100% as I did everything I was told to do and more. How quickly does this bone loss progress in this situation? There is no pain, no swelling, no infection, at this time. Long story but the surgeon who placed it is not going to be taking it out. The implant is Nobel active regular size implant. This implant is on the end, I think #29? it is critical to the success of the treatment plan and placing a non removable prosthesis

    Reply
    1. RamseyAminDDS Post author

      I would take it out and replace it right away. If it is the terminal and of a fixed lower bridge such as a Prettau dental implant bridge, it needs to be solid. You only encounter problems 1 to 5 years later if it is left alone. Oral hygiene can play a part but it is not the only reason it implant can begin to lose bone early. Bone loss around dental implants tends to be progressive especially if it is on the outer wall. I know this is not what you wanted to hear but I would rather give you solid and truthful information that you can use.

      The very problem you describe is exactly why I place all implants in a unique position much closer to the time in order to have the thickest bone possible on the outer wall and have it be stable for the next 20 years. It is possible that this was just a thin bone area and there is no option to place it closer to the tongue.

      Reply
  6. Linda

    I like your analysis of bone loss which I have had since the eighties.

    3 implants in the upper right quadrant hair place by Mexico dentist in 2000 I believe.

    Now I have at least one that is loose and I think I’d like to glue it however I know the importance of bones and teeth and stuff.

    Have an appointment the 25th of January at West River periodontics and I believe this guy is a problem solver will see!

    Thank you for sharing your knowledge.

    Reply
    1. RamseyAminDDS Post author

      You would have to be unusually severe and on more than just one tooth to cause an infection beyond the area of the teeth. If you have a compromised immune system it could spread something faster but typically the health concerns are limited to the mouth but inflammation anywhere in the body is not good for you.

      Reply
  7. Shanna

    One of my dental implants, placed in May 2016, has significant bone loss around the implant. The plan is to remove it, clean it thoroughly, more bone grafting and try the implant process again. My concern is whether this is a matter of malpractice or bad luck. I didn’t have any symptoms until two months after the placement of the crowns which I can’t help but wonder if my dentist did something improperly? I might add I am only 21 years old with no health conditions (to my knowledge) contributing to the bone loss.

    Reply
    1. RamseyAminDDS Post author

      It happens to the best of dentists and the best of patients. Just make sure your DDS is very experienced and of course have a scan before placement.
      I would suggest you wait six months before you place the second implant.

      Reply
  8. Mary

    Hi..I have had 2 dental implants , lower right, 1 which is now infected, taking Clindimycin since 10/11, was advised to try to save the implant even thought ex rays show 50% bone loss..My surgeon says I’m in the grey area..I’m considering removing it. I’m really torn because it’s so expensive , and if bone grafting doesn’t take then I have to add the expense of removing it. and choose to do a bridge with a supported implant on one end and natural tooth with Crown molar, which is rather short
    .Don’t know if the supporting teeth will support the bridge as I have strong bite..Lots of anxiety over what to do.

    Reply
    1. RamseyAminDDS Post author

      If you’ve lost 50% of the surrounding bone in a 360° direction then your best removing the implant. No one on this planet can rebuild bone 360° around the implant that has 50% loss

      I know that is not what you want to hear but believe me this is a better choice.

      Reply
  9. Judy Kammer

    Tooth #8 – I had bone graft surgery and implant surgery in April 10, 2015 and implant 11/13/15. On May 9, 2016, the crown was cemented in by another dentist. By June 8th, I had an abscess. I visited both the surgeon and the restoration dentist on that day. The surgeon declared it wasn’t the implant and the dentist cleaned the tissue and I returned on 6/13, 6/29, and, 7/6. I was advised to return to the surgeon at the 7/6 appt. On 7/7/16, I saw the surgeon. He cleaned up the gum and said no anti-biotics were needed. I returned 7/12 and on 7/15, the surgeon backed out the abutment just a little. By this time the crown was broken off and removed by the dentist. Reversing the abutment began the healing process.
    On 9/14, after a re-check the dentist re-installed the temporary. When I was leaving, I mentioned the tooth felt like it moved a little. As it turns out, I had to return on 9/15 (next day) because the abutment was loose.
    On 10/3/16, I returned t the dentist for a new temporary so we could see how the tissue reacted. The next day, I bit into something with the tooth next to it and heard a loud snap. October 4th, back to the dentist. I broke the screw on the temporary. He then set the permanent tooth in place but did not cement it because the color needed one more tweak.
    I visited the lab on 10/6 and left with the crown. On 10/7 I returned to the dentist and he cemented the crown in place.
    Today is Monday, 10/10/16 and the tissue has begun to ache and it looks darker. It is becoming more tender when I touch above my lip. At this juncture, I do not know whom to visit. From what I have read now that I am researching this, I am guessing I should have a 3D x-ray.
    If you have any intuition as to what may be happening I welcome advice. After the first crown was removed, the tissue healed and the only thing irritating it was the temporary crown movement. I live in the northern suburbs of IL, Crystal Lake.

    Reply
    1. RamseyAminDDS Post author

      Very odd. I think the implant is failing or the abutment is loose. Both are uncomfortable and uncommon. Get a pa xray and a 3D ASAP.

      Reply
  10. Greg Toto

    6 implants on upper jaw with a hybrid one piece fixed bridge. One implant upper left quad has severe bone loss after 15 years. Can I have another hybrid made and use the 5 implants that don’t have bone loss and remove the bad implant. Looking for least expensive option. I’m not working right now.

    Reply
    1. RamseyAminDDS Post author

      This is exactly why I do not suggest the all on 4 procedure were only 4 implants are used to support an entire bridge. Your situation permanently describes how you can remove one dental implant and typically continue to use the same bridge or modified. If you’re existing 5 implants are solid by all means try to make a new bridge just using the 5 of them or modify your existing.

      Reply
  11. Christine

    Hi there,

    Aug 2012 I had a root canal extracted, synthetic bone build up and implant put in behind my canine tooth (top left side).
    The implant is between 2 root canaled teeth.

    It healed good. Then I had the tooth put on the implant Feb 2013.

    I started getting a bad metallic taste in my mouth. It was constant. Feels like something sloughing in my mouth.

    I went to the surgeon twice
    about the taste/sloughing but after taking a 2d image said it looked fine and blamed it on nerve pain.

    After 1 year I had the tooth removed from implant.
    Hoping the taste would go away but it did not.

    Taste is still there .

    Sept 2016 I saw another surgeon about a tooth behind the implant.
    He took a 3D X-ray.
    He said that 1/2 the bone if fine but 1/2 of the bone on the other side is gone.

    Why would this happen?
    What are my options?
    Can you give me any advise or recommendation?
    I have been tasting this for about 3-4 years. Could I be tasting the bone sloughing ?
    I taste metallic, blood and burntness that is getting worse all the time.

    I appreciate any advise you can give me.

    Thanks
    Christine

    Reply
    1. RamseyAminDDS Post author

      We don’t know why on 100% of all cases. And my practice about 1% of patients will develop this condition. You may want to cut your losses and remove the implant and start all over again. I know you don’t want to hear that but often it is the best advice. 50% bone loss is extreme. It needs to be removed ASAP.

      Reply
  12. Amber

    My mother has peri-implantitis. Her dentist told her to go to an oral surgeon to have all of her implants removed, because the inflammation and infection is so bad. She doesn’t want to have surgery so she is refusing to go to the oral surgeon. What could happen if she continues to refuse to get them removed ?
    Thank you for your help!

    Reply
    1. RamseyAminDDS Post author

      Continued bone loss and chronic long term low grade infection. So sad…..all of them???? That is so rare.
      Her bone may be the type that just dissolves over time.

      Reply
  13. Alicia Lowery

    I had two failed bicon implants, teeth #4 & #5. I have endured unbelievable pain even now after second one was surgically removed. The first was removed by hand, no instrument required. Now months have passed and some days I continue to have incredible pain from the site. The bone loss has continued and I am greatly concerned as to if and when the bone loss and pain will ever stop. According to the second dentist who removed the implant, the initial implants were not properly placed. The implant he removed was infected as well as the first. I also explained to the initial dentist I’d been diagnosed with osteoporosis and he said that should not be an issue. I now have a partial I seldom wear. Please advise. Where are you located? Thank you!

    Reply
    1. RamseyAminDDS Post author

      are you sure it is not another tooth like tooth #3 or tooth #7?????…. Believe it or not, this happens more often than you think where pain is coming from an adjacent tooth and the patient does not even know it. I am located in Burbank California.
      This is very odd and I can see how it is troubling you!!

      Reply
    2. Elaine Pivirotto

      Paid DR. Xxx. Xxxxx of Englewood N.J. $29,000.00 for my dental implants, they were not proper placed, the uper denture rocked in my mouth had a bar across the top of implants bar broke snap on denture after 5 mouths the clips wore out, made of plastic, he tried different clips ,still got loose,he was not explaining why , his receptionist Heather told me to look for new dentist .
      She told me if in any pain they will give me medication for 30 days ,I can no longer be his patient ,after 10 yrs a 93 yrs old dentist told me the answer ,it rocks ,I had front teeth on the bottom, minus a total of 4 back teeth Dr. Matriess said ,I had no foundation, can’t build a house with a full foundation.

      Reply
  14. Nancy K.

    I had an unsuccessful dental implant that originally took, I also had grafting, then the bone around it desinigerated. What could be some reasons for that? Might another be successful? I also heard that being on an antidepressant or other RXs might affect the implant! Are there prescriptions that might be a factor in the loss?

    Reply
    1. RamseyAminDDS Post author

      All of the things you have said so far are correct. Yes some antidepressant medications are known to have negative effects on dental implants.

      Another implant will likely work even though the first did not. Often times bone is lost for no reason at all but often there are significant medical or dental issues that have caused it.

      Reply
      1. Susan

        Hi Dr Ramsey
        I wish you were in Houston:) I had all on 4 about 3 yrs ago I think I have 2 implants in front trying to fail!!! I have lost a lot of bone . I’m on my second set of teeth 26000.00later and still not done!!!! Looking at possible grafting next!!!!

        Reply
        1. RamseyAminDDS Post author

          Ugh. This is why I strongly suggest against the all on four. There is no “back door” to escape…no spare tire….you have to throw away the whole car.

          I recently had one implant not take on an upper “all on 8”. The solution was just to remove it and now it is still a strong “all on 7”.

          The solution is to unfortunately start over but please design it with minimum six implants for the upper and make sure there is thick bone on the outside of all implant. This is the only way this is going to last.

          Reply
  15. Donna Spangler

    I have minor peri implantitis at one of multiple implants. My dentist sent me to a periodontist who wants to do gum grafting around the implant. The only issue I am having is sensitivity when I floss and water pik. Is this a recommended procedure?

    Reply
    1. RamseyAminDDS Post author

      If you are losing bone, it is often progressive leading to the loss of the implant. Generally a 3-D scan would be suggested to evaluate the position of the bone loss. I would suggest you do this before any type of rescue procedure.

      Reply
  16. Kari Ash

    I had a dental implant a few years ago and on my recent 6 month cleaning/X-rays, a new dentist (we moved states) noticed I had bone loss in the area. He questioned the length of screw used. My formEr dentist did prep work, been with practice for 13 yrs, felt confident in their work and referral of endodist who performed procedure. My current dentist suggested a low level laser to regenerate bone(I had no pain prior to this) which will be 3 weeks tomorrow I had it done. I still feel pain and having to take at least 8 Advil a day. Called back after first week of having procedure done & they took X-ray, said everything looked good, still experiencing pain after 2nd wk, told to give it another week and I still have dull ache today. Is this normal or is X-ray not showing an infection, something is going on. I even took norco prescription (3 days and didn’t have much relief. Thanks for any insight you can give me. Questioning this new dentist????

    Reply
    1. RamseyAminDDS Post author

      low level laser treatment may reduce the pocket but will not likely regenerate bone. Peri-implantitis is difficult to treat without surgically opened in the area and doing a bone graft/smoothing threads off of the implant/cleaning all the inflamed tissue out. It is not normal to have pain this long. I would go back and have another follow-up visit.

      Reply
  17. drbipinsadhwani

    I want to share one case of implant placed in maxillary premolar region in 45 yes female….I HV xray record pl send me your email I’d so I can share xrays

    Reply
    1. RamseyAminDDS Post author

      That implant has lost a tremendous amount of bone. You would be much better off removing it entirely and starting over. It will be forever compromised should you decide to keep it.

      Ramsey Amin DDS

      Reply
  18. Tina Taylor

    I had a dental implant done on tooth #10 January 22, 2015. I learned in October via Xray that I have none loss. The periodontist says the implant is stable. However, I have 3 threads exposed. No other symptoms. However he says I need to wait another 3 months because it has not been a year for the osteointegration needs the full year. Then he will reexamine and will plan for a debridement and procedure for bone grafts. Do you agree that we need to wait the 3 months?

    Reply
    1. RamseyAminDDS Post author

      1 year is a good milestone before attempting intervention on a new implant as long as it is not progressing quickly.

      Reply
  19. lina Mezher

    I have major problem with implant bone loss due to bone grafting, and I would like to come for consultation at your office. Do you charge for consultation or is it free.
    Please let me know so I can schedule an appointment.
    Thank You.

    Reply
    1. RamseyAminDDS Post author

      Hi Lina,

      I would be happy to help you personally. The best thing for you to do would be to call and speak to one of my front office receptionists. They are highly skilled and would be able to answer all of your questions. There is a charge for the initial consultation.

      Office phone number: 818-846-3203

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  20. Herman Gallegos

    My Hygienist has me using Perio Gel on on molded plastic trays 4 times a day for 15 minutes everyday. Is this another method to treat implantitis?

    Reply
    1. RamseyAminDDS Post author

      It may buy you time depending on the condition and the extent of the peri-implantitis. If the threads are exposed and a 360° pattern, there will be fewer options for successful procedures. If you have a one-sided bone defect, that may be able to be grafted.

      Good luck,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  21. Michael M

    I had a Prettau cement retained full lower bridge using 6 implants. placed in Feb. 2015 and a separate implant and zirconia crown on tooth #19 at the same time. I complained about minor pain at the time, and it continued. Went back a month ago. They didn’t see anything with an Xray and cleaned the bridge. Two weeks ago I started to experience real pain all around that implant with no let up . I am going back on Monday,But I decided to do my own research as I have all during the process over 3 years. and now I think I am facing what you describe in you article. I won’t hesitate to have the implant removed, because I don’t need it. Prior to the implants I lived with with a cantilevered bridge hanging on 4 teeth with crowns. all the way to tooth 18 for 28 years. . There is no pain at implant 18 so I can hope the bridge and bone will survive. But I won’t be surprised to hear them say the best thing is to remove the implant. Sound about right???

    Reply
    1. RamseyAminDDS Post author

      If it is deemed that the implant has so much bone loss that cannot be corrected, the best option is to remove the implant like you said.

      Peri-implantitis can affect a few implants. My guess is your bone and/or gum is very thin in that area which is a risk factor for developing peri-implantitis.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  22. Ronnie

    I have 5 teeth in front at the bottom and 6 teeth in front at top. Then I have one 3 tooth bridge and a tooth on my bottom right. Rest are all gone. I am wondering if I should get all implants or 3 implant bridges- for top left, bottom left, and top right jaw? Or something else. These implant bridges will be on replacing the chewing areas; will they be stable?

    Reply
    1. RamseyAminDDS Post author

      Hello Ronnie,

      I do not have enough information about the 5 teeth in the front at the bottom and the 6 teeth in the front at the top. Obviously I would need to see x-rays and 3-D scans in order to steer you in the right direction. Oftentimes the remaining front teeth are the last wants to go but have significant bone loss or not strategically favorable for reconstructing the whole mouth.

      The decision to make 3 segmented Bridges versus a one-piece is very unique to each person. Segmentation is always nice because it allows you to maintain the most natural feeling teeth possible. That being said a requires more implants and more bone to be able to do this.

      Whenever you decide to do dental implants are extremely stable when placed correctly and when the teeth are made correctly. Hopefully you get 20 years out of them.

      I believe on another post you asked if I could personally review your scans and do a consult with you because you do not live in the area. Call my office if this is something you would like to arrange.

      Respectfully,

      Ramsey Amin DDS

      Reply
  23. Norma

    Hi, I am missing one top molar on each side. I never wore braces but did wear a retainer when I was about 17 to close the gap in my front teeth. Before losing molars about 20 years ago, I had pretty straight and nice teeth. About 1/2 a year ago I noticed my gap slowly opening n I hate it. Could I get a retainer to close again? Would I have to replace missing molars to get braces like Invisalign? Please let me know what my options are to close gap. At this point I feel too much time has passed to replace molars since it was 20 years ago and am sure of the bone loss. I am 44 yrs old.
    More depressed every day.

    Reply
    1. Ramsey Amin DDS

      Hello Norma,

      Because the top molars have been missing for so long, you will likely need some type of sinus bone grafting. This can be a simple as an internal sinus lift or you may possibly require a lateral window sinus bone graft. Both of these procedures are extremely predictable and normal procedures that I perform multiple times a week. They are not rare or experimental.

      There is no way for me to be able to completely tell you whether the gap can be closed with braces alone. You would need to see a dentist for a complete evaluation with x-rays.

      Sinus Lift Bone Graft

      Very Respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply
  24. rudy

    I have recently been told that I can not have implants due to bone loss. I still have all my teeth, but it’s getting worse. Can the bone graft procedure be done in my case.

    Reply
    1. Ramsey Amin DDS

      Hello Rudy,

      Keep in mind that bone grafting can be done to rebuild most situations. There are times though where bone grafting will not work and other alternatives such as a bridge may become a better option. there are many different techniques of bone grafting and it will be highly dependent on your unique situation. In almost every situation I can rebuild bone to have implants. Sometimes if the implant is in the very front of the mouth on the upper and bone is missing on the palate, then there are issues building bone vertically.

      I Don’t Have Enough Bone For Dental Implants

      respectfully,

      Ramsey Amin DDS

      Reply
  25. Sonia

    I had this problem and I ended up losing the implant. I wish I would’ve gone to a more experienced dentist. I went to one of those radial advertisement places… What joked it was. I should’ve gone with my gut feeling….now I need a pretty massive bone grafts in order to have another implant. The dentist that I saw said the implant was put in so deep in so far to the outside that it was going to lose bone no matter what.

    Reply
    1. Ramsey Amin DDS

      Hi Sonia,

      Sorry to hear about your mess. I have seen this too many times. There is no doubt that experience counts. Make sure you see a really expert provider to replace the implant a second time. Most dental implants last somewhere from 15-30 years.

      Sometimes peri-implantitis cannot be avoided and is unknown, but it sounds like you and your case there was issues with the position of the implant.

      The angle of the implant is really important.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

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