Q: I’m in my seventies, in good shape and looking to improve my dental health. My lower teeth are pretty good but many years ago I lost a number of teeth in an accident on my upper left. I think four or five teeth were lost and have been gone for twenty-five plus years.
Fifteen years ago, I got a partial denture that has given me my smile and some function. In the past months, I’ve been talking with friends who have new teeth because of implants. I thought I’d investigate that option so I saw a dentist and he said that the bone where the teeth were lost is OK for the partial but not thick enough for implants. He said if I really wanted implants I’d need bone grafting so I might need a couple operations to get them in there. He said I have enough height but the thickness was just under four millimeters. He said that I’d need implants that were four millimeters in diameter at least.
I’m a bit of a handy man and even I know you can’t drill a four-millimeter hole in a three-millimeter board. I was ready to give up but then I thought there’s always a way to engineer the impossible so what do you say? Is there a way? My teeth on the upper right have some problems. They just don’t feel strong and I know it’s only a matter of time before they break down. Please advise.
A: Much of the time bone thickness is the problem for implant placement. There are many ways that the thickness can be increased to make implants possible. Here are three.
The first is adding bone to your bone. After four to six months, you’ll enough width for your implants. In your case two or three implants will be required to take forces required of them.
The second depends on the shape of your bone. Often the crest of the bone or ridge is narrowest and the base is broadest. Usually half way to the base the bone is thick enough for the implant. If this is the case some dentists like to place implants into bone so that most of the implant is covered completely in bone and the last part can be covered with bone grafting. Six months later it’s ready for crowns.
The last technique is one of bone expansion. Your bone has an outside and inside wall. The very crest or edge allows entry to spreading forces for the walls to be pushed apart. A three-and-a-half-millimeter ridge may be pushed so that the width is six or seven millimeters wide, allowing four millimeter implants to be placed. If your bone meets this technique’s requirement it will require less time than the techniques described above.
Once accomplished you have many options that will provide a secure, healthy, and handsome bite.