Bone grafting for Nobel implants
Rebuilding the site when there is not enough bone to hold an implant
An implant needs bone around it on every side. Where a tooth has been missing for years, or was lost to infection or a fracture, the ridge may be too narrow or too short for that. Bone grafting rebuilds the site so an implant can be placed — sometimes at the same visit as the graft, sometimes months later once the graft has matured. It adds time and cost to treatment, which is precisely why it should be discussed openly rather than discovered halfway through.
How the treatment runs
-
Assessment
CBCT assessment measures the width and height of bone actually available, which a flat radiograph cannot show.
-
Graft placement
Graft material is placed at the deficient site and protected while it consolidates.
-
Healing
The graft matures over months. The exact period depends on the size and type of the defect.
-
Implant placement
The implant is placed once the site can hold it — at the same visit in smaller cases, later in larger ones.
Alternatives you should know about
- Placing implants elsewhere in the jaw where bone is adequate, if the prosthetic plan allows
- Angled implant placement to use existing bone instead of rebuilding it
- Zygomatic anchorage, in severe upper-jaw cases
- A removable prosthesis, avoiding surgery
Why bone disappears
Bone that carries a tooth is maintained by that tooth. Chewing transmits load through the root into the surrounding bone, and the bone responds by keeping itself dense. Remove the tooth and the signal stops. The ridge narrows first, then shortens, most rapidly in the first year and more slowly afterwards.
This is why the question “how long has the tooth been missing?” is asked at assessment. A gap of six months and a gap of fifteen years are different surgical propositions even when they look identical in the mirror.
Why a panoramic radiograph is not enough
A panoramic image is a flat picture. It shows height reasonably well and width not at all — and width is usually what is missing. A ridge can look perfectly adequate on a panoramic radiograph and turn out, on a CBCT scan, to be a knife-edge a few millimetres across.
That is the single most common reason a treatment plan changes between an online quote and the clinic. It is also avoidable: a CBCT before travelling means the plan you are quoted is the plan you receive.
Grafting is not always the answer
Sometimes the better route is to avoid the deficient site rather than rebuild it. Angling implants into bone that is still present, moving the implant position along the ridge, or redesigning the prosthesis so it does not need support at that exact point can all remove the need for a graft.
Whether that is possible depends on the plan for the teeth. It is another instance of the same principle running through implant treatment: the prosthetic design and the surgical plan are decided together.
Getting an assessment
Send a CBCT scan if you have one, or a panoramic radiograph, with a note on how long the teeth have been missing. The clinical team at Taki Dent can review it and set out whether grafting is likely to be needed, whether it would be simultaneous or staged, and what that means for time and cost. A final plan is confirmed after clinical examination and radiological assessment at the clinic.