First off I want to be clear that you cannot have dental implants without having enough bone to support dental implants. BUT…sometimes you don’t need to rebuild ALL the bone to have the same result. Sometimes rebuilding ALL the bone does not yield as nice of a result than if you bone grafted back just SOME of the bone and used smaller, shorter dental implants.
This is most critical in the front of the mouth where the smile and how the dental implant or bridge looks. The look of the gumline is just as important as the look of the teeth!
Many times the result is far better building missing gum tissue with porcelain than it is by gum grafting or adding bone through surgery! Even with the best implant dentist in Los Angeles, rebuilding the “details” of your gums back is the at best unpredictable if you are missing bone in a vertical direction. I perform about twenty different types of bone grafts and am very successful at it.
Even if you build back 90% of the bone defect, that last 10% is what makes a smile perfect, or what makes it look fake! This is a good example:
The patient below came to me with dental implants already placed and wanted a fixed, cemented dental implant bridge. She did not want to have to click in and out her teeth daily and have an overdenture.
As you can see there is no bone there! She is missing most of the bone to the base of the nose and ten teeth are missing. Many dentists would say “you can’t do implant or a fixed bridge here.”
In her case, I rebuilt her smile of 11 teeth using five dental implants, a porcelain bridge and very detailed “pink porcelain.” Pink porcelain is really not pink, it is many shades and has a certain texture. By building this bridge using pink gum colored porcelain I avoided her having to rebuild massive amounts of bone in the front of her mouth, that would take about 2 years and many surgeries.
Of course, there are downsides to this approach as there are to any approach, but in the front of the mouth, the results are great. This is a technique that I have used for the last 11 years. Very few lab technicians in the world are talented enough to do this type of work.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry