Bone Augmentation. When There Isn’t Enough Bone for a Successful Implant.

A topic not suitable for children or the faint-hearted.

For an implant to function reliably in the long term, it needs to be surrounded by a sufficient amount of hard and soft tissues (bone and mucosa), in addition to thorough cleaning and regular care. In situations where there is not enough bone to place an implant, we use procedures that increase bone volume — bone augmentation. Whether there is enough bone is determined by a 3D CBCT scan, which we take during the consultation, as our clinic has its own CT device.

We prefer using the patient’s own bone, which we harvest from specific areas of the oral cavity as gently as possible using piezosurgery and special bone scrapers. At the same time, we fully utilize the bone collected directly from the site being prepared for implant placement, ensuring that no tissue goes to waste. We then fix the harvested bone in the required areas using special screws, fill the empty spaces with the collected bone “shavings,” which are more permeable for newly forming blood vessels that provide nutrition, suture the site tightly, and let it heal. After the bone heals—which typically takes 4 months—we place the implant and continue with shaping the gum around the implant, scanning the area, and fabricating the crown on the appropriate abutment. The bone at the donor site also heals and can be used again in the future for another implant.

In rare, well-indicated cases, we also use artificial bone, which we cover with various types of membranes. Most often, we use it immediately after an extraction to fill the space left after the roots so that the mucosa does not collapse into the empty cavity.

Other techniques we use include bone condensation with special drills or splitting the bone and expanding it using piezosurgery.

We always choose an approach that provides the greatest benefit for the patient and the future implant in the given anatomical situation, while remaining as minimally invasive as possible.

Our next blog covers soft-tissue augmentation.

MDDr. Július Ročkár