On the occasion of this article I want to address those of you who have been told at some point that you lacked sufficient bone for a dental implant to be applied in that region.

In addition to dental extractions, there are several other reasons why you have lost significant bone volume. I shall mention some of them:

  • Acute, aggressive infections of the tooth in question;
  • Untreated chronic dental infections;
  • Inadvertent and/or aggressive extractions, without paying attention to the adjacent alveolar bone (iatrogen);
  • Accidental traumas;
  • Post-extraction long-term etc.

Whatever the reason may have been, at this point, in the area of the tooth in question, you lack sufficient bone volume for a dental implant to be inserted.

That’s why I will present in more detail so you can understand the ideal solution for treatment, namely bone addition. I am not going to detail the existing surgical techniques (I do not consider it’s of any interest to the reader, but if you are willing to learn more, I shall be at your disposal), but I will try to create an image of what bone addition is, regardless its type. There are 3 categories of bone addition:

1. HORIZONTAL BONE ADDITION: is performed when we have sufficient bone height, but we lack the thickness required for a dental implant.

In terms of the techniques used, I could list the following: bone-split, bone expansion, lateral bone addition with collagen membrane and/or titanium membrane protection.


2. VERTICAL BONE ADDITION: is performed when we have the thickness necessary to insert a dental implant, but we lack the necessary height.

In terms of the techniques used, I mention: external sinus lift (Caldwell-Luc procedure), internal sinus lift, bone grafting, bone augmentation.

3. COMBINED VERTICAL/HORIZONTAL BONE ADDITIONS: is performed when there is a lack of both the height and the thickness necessary for inserting a dental implant.


After all my experience as dentoalveolar surgeon and implantologist, I would have the following advice for you:

  1. It is preferable to use autologous bone (your transplanted bone), thus creating henceforth the most qualitative bone tissue for receiving a future dental implant;
  2. It is preferable to use best quality biomaterials, even if they increase the price of bone addition, the bone addition-price ratio creating the reliability and quality of the adjacent bone;
  3. I recommend maximum attention to the following extractions you shall undergo, you should therefore keep in mind preserving the bone so that you do not get back into the situation of requiring bone addition;
  4. It takes quite a long time to heal, so do not rush into having the desired tooth in your mouth (the final result of bone addition, followed by the dental implant).

I hope this helps and I’m open to any questions if there are any unclear aspects.

All the best,

Dr. Sorin Gageanu

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