I am missing an upper molar and I don’t have enough bone for an implant. I need a bone graft, but can you explain the details and my options?
In the upper molar area the maxillary sinus drops down and reduces the amount of bone available for the placement of an implant of adequate length. This means that you need a bone graft to increase the amount of bone available, or you need to place a short implant.
Most reputable textbooks on implantology recommend a minimum implant length and associate short implants with a higher incidence of failure, so I do not recommend the placement of short implants.
As far as the bone graft is concerned, there are two methods to graft the sinus.
If the amount of bone available is deficient by only two or three millimiters, I will do an osteotome sinus elevation. This is done through the implant osteotomy and is the less invasive of the two. You elevate the membrane with the graft and then place the implant the same day.
If the deficiency is greater than three or four millimeters, then I prefer a lateral window approach, where the schnederian (sinus) membrane can be pushed up as much as needed without increasing the risk of a tear. Then wait six months before placing the implants.
Implant Dentist in West Palm Beach
Carlos Boudet, DDS DICOI
1840 Forest Hill Blvd, Suite 204
West Palm Beach, Florida 33406
Phone: Call 561-968-6022