Dental implants are the most reliable way to replace missing teeth with lasting results. However, there’s a catch: The most common types of implants—called endosteal implants—are inserted directly into the jawbone and thus require a certain level of bone density.
So what if you have bone loss? Does that mean dental implants are completely out of the question?
The direct answer is no, you can still get dental implants even with a certain degree of jawbone loss. This is actually one of the most common questions restorative dentists face: “Can I still get implants if my jawbone is thin?”
Let me answer this common question in detail.
Why Bone Density Matters for Dental Implants
Dental implants rely on a process called osseointegration, which is essentially the fusing of the artificial post with natural bone tissue. This bond provides implants with the exceptional stability needed to support prosthetic teeth. Basically, fusing with your jawbone allows dental implants to function very much like a natural tooth root.
The early forms of dental implants relied almost exclusively on having jawbone support. Dentists typically drill the implant directly into the jawbone. Therefore, a certain degree of bone density is essential for receiving some types of implants.
Unfortunately, bone loss quite commonly accompanies tooth loss. Other factors that contribute to tooth loss, such as periodontal disease, can also contribute to bone loss. Most implant recipients tend to be in their senior years, which makes them more likely to have bone-related diseases like osteoporosis, further complicating the process of receiving implants.
However, implant dentistry has come a long way since its early years. Nowadays, it’s possible to get implant-supported teeth even with some bone loss. Let me explain how.
How to Receive Dental Implants Even if You Have Some Degree of Bone Loss in the Jaw
Endosteal implants—or the type of implants that are directly inserted into the jawbone—is only one type of implant in modern dentistry. We now have implants that can be inserted into the gumline (above the jawbone) or into the cheekbones, bypassing bone density issues in the jaw.
Advanced techniques for placing implants also allow dentists to manage implants with some bone loss. Here is a list of options you can consider:
Implants with Bone Grafting
For serious cases of bone loss, bone grafting remains the go-to solution. Bone grafting is a surgical procedure and is usually performed separately from implant surgery. It uses a grafting material—which can be either bone sourced from the patient, donors, or a lab-developed synthetic version—to rebuild lost bone.
The grafting material is inserted into areas lacking bone tissue, and within several months following the surgery, the graft material slowly integrates into the existing jawbone, making it denser than it used to be.
Patients who undergo bone grafting must first heal from the procedure before undergoing implant surgery, which has its own months-long recovery period. Smile restoration takes much longer if bone grafting is necessary, but almost all patients find the long wait worth it for regaining their smiles.
Zygomatic Implants
You don’t have to worry about jawbone loss if the implants are not drilled into the jawbone in the first place! Zygomatic implants are inserted into your cheekbone, which is medically called the zygoma bone, hence the name.
Zygomatic implants offer excellent stability, much like traditional (endosteal) implants. Most patients can bypass bone grafting surgery with these types of implants. The only caveat is that they can only be inserted into the upper jaw, as the cheekbone doesn’t extend down to the lower jaw.
For those who need full-mouth smile restoration, dentists offer hybrid implants, which combine zygomatic implants with other implants in the lower jaw. In some cases, patients can receive bone grafting only in the lower jaw and get zygomatic implants for the upper for dependable full smile restoration.
Subperiosteal Implants
Subperiosteal refers to the thin layer of tissue that sits on top of your jawbone, right under the gumline. Unlike traditional implants, subperiosteal implants are inserted into this tissue layer if there isn’t enough jawbone to support a titanium implant. So these implants rest on top of the jawbone, but beneath the gumline, so nothing juts out into your mouth.
Unlike traditional implants, dentists design a metal frame to support subperiosteal implants, so they offer the same stability and durability as regular implants. The artificial crowns or bridges are attached to this framework, fully restoring the smile.
Subperiosteal implants are recommended for patients who have bone loss but cannot undergo bone grafting surgery or receive zygomatic implants.
All-on-4
The popular All-on-4 implants use just 4 implants per jaw to support a full arch of teeth. One major advantage of this technique is that it allows many to forgo bone grafting. All-on-4 implants are strategically placed to maximise the use of available bone without compromising stability, making this technique ideal for most cases of smile restoration.
The downside is that All-on-4 is only suited for mostly mild cases of jawbone loss. The implants are still inserted into the jawbone, so patients must have some degree of bone density. For moderate to severe jawbone loss, dentists may recommend subperiosteal or zygomatic implants.
Benefits of Implants Despite Bone Loss
There are several important reasons why choosing implants can be highly beneficial, even with some bone loss. Let’s take a look:
- Fully restore the ability to chew normally and transition out of soft-food diets.
- Restore speech clarity
- Save facial structure. Jawbone loss and missing teeth can lead to the “sunken face” syndrome, where your face gradually loses its natural shape.
- Prevent further bone loss in the mouth.
- Long-term smile restoration. Implants can last decades with proper aftercare.
Making Your Decision Regarding Specialised Implants
Receiving implants with some bone loss can be more expensive, especially if bone grafting is involved. There are also medical considerations to take into account, especially if the bone loss is caused by diseases like osteoporosis. Implantologists do a full cost-benefit analysis before recommending implants for patients with low jawbone density.
For most patients, the toughest decisions come down to finances. In the short term, implants may seem costly. However, they offer many long-term benefits that nearly all patients who choose implants do not regret their decision. With carefully managed post-surgical recovery and proper oral hygiene, dental implants can benefit your overall health for years to come.
Image source: https://www.freepik.com/free-photo/dentist-doing-check-up-patient_21085312.htm#
Author Bio
Dr Malavi Sivakanesan is the co-founder and principal clinician at the Complete Smiles dental clinic in Bournemouth. She has a special interest in edentulism (adult tooth loss). Outside of managing the Complete Smiles clinics in the UK and Norway, Dr Sivakanesan is a dedicated advocate for affordable dental care.
