I have been told I need a block graft and an implant. Is there another alternative?

I have bone loss around one of my two upper central incisors. The tooth looks a little longer than the other central and it has to be extracted.  I have been told I need a block graft and an implant, but I don’t like the idea of a second surgery to take a piece of bone from my jaw, and prefer an implant instead of a bridge.  Is there another alternative?

These are the alternatives for augmenting the amount of the bone in an extraction site:
1- A Bone Graft with particulate bone, for augmenting the width , or
2- A Block Graft from another area in your jaw (preferable) or from a cadaver, to augment both width and height, which is what you need if your tooth appears longer than the adjacent central.
3- A third alternative is Distraction Osteogenesis, but in that area of the mouth, and because of cosmetic concerns, I doubt it would be acceptable to you.
4- A fourth alternative, which is Crown Lengthening Surgery, I would only consider if your front teeth seem short for your smile because it removes bone from around the teeth.
The last alternative, and the one I would recommend is called Forced Orthodontic Eruption, and it utilizes braces to slowly pull the tooth out, which physiologically brings the attachment (the bone and the gums) with it.  This allows the gums to be at the same level, for teeth that look even instead of one longer than the other, and it avoids the need for block graft surgery.

Carlos Boudet, DDS, DICOI
Dentist in West Palm Beach

About Carlos Boudet, DDS, DICOI

Dr. Boudet is a graduate of the Medical College of Virginia. After graduating with a DDS degree in 1980, he became a commissioned officer for the United States Public Health Service. When his tour of duty ended in 1982 he received an award for outstanding service. He was asked to serve as Dental Director for Florida Community Heath Centers, supervise the operation of four dental clinics around lake Okeechobee. He established his dental practice in West Palm Beach in 1983 and has been in the same location for 30 years. He is a Diplomate of the International Congress of Oral Implantologists, a member of the Central Palm Beach County Dental Society and a chairman of the Advanced Crown and Bridge course of the Atlantic Coast Dental Research Clinic. His articles on prosthodontics and implants have been published in several popular dental magazines.


  1. Question:
    How is it that general dentists, oral surgeons, and periodontists all do implants? Who should I go see if I need an implant?

    All dentists possesing a degree of DDS or DMD and a license to practice dentistry are allowed by law to place implants, however, the science of implantology is one of the most demanding aspects of general dentistry and requires extensive knowledge that can only be obtained by additional study and training.

    The American Dental Association and the Board of Dentistry do not recognize Implantology as a specialty in dentistry, and it is taught to a limited extent in dental school.

    As dental implants are getting more successful and popular, the percentage of general dentists that are doing implant surgery is increasing. Periodontists and oral surgeons are also involved as part or an interdiciplinary team in the surgical placement of implants.

    The most important detail is the need for correct diagnosis and treatment planning. This will create a blueprint for treatment that will be functional, cosmetic and comfortable. Only a properly trained dentist in both the placement and the restoration of implants can do that. It is my strong belief that a properly trained general dentist is the most qualified professional to provide such a treatment plan.

    There are organizations dedicated to advancing the science of implantology that provide certification as a means to demonstrate knowledge in the field such as the ICOI and the ABOI. Anyone needing implants may want to inquire into the credentials held by the dentist.

    Carlos Boudet, DDS, DICOI

  2. Sorry for my bad english. Thank you so much for your good post. Your post helped me in my college assignment, If you can provide me more details please email me.

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