Category: dental implant

When is it necessary to get a dental bone graft?

Posted on by Gary Adams DDS

What happens if you don’t get a bone graft?

A bone graft is necessary if there is a hole in your jaw (extraction site) from having a tooth taken out. What happens if you don’t get a bone graft is gum tissue will grow down into the jaw and the bone will not heal properly. The gum tissue can stay living in the jaw for years along with bacteria, viruses and fungus. Dentists call this bone pathology. The areas of bone “pathology” or infection can contribute to systemic disease. And infected bone is not suitable for dental implants. Bone grafts add more expense, but in the long run it will save your health and save you from more expensive bone grafting and bone pathology treatments in the future.

Do you need to get a bone graft for an Implant?

Dental surgeons are asked this one all the time. Many of our patients are surprised to hear the answer. Most likely, no—you will likely not need to get a bone graft, should you elect to have dental implant surgery. There are some cases where a bone graft may produce a better result. Other examples where PRF can be used as a graft product in place of bone from a horse or cadaver as are usually used. But is it necessary to get a bone graft for a dental implant?

bone graft necessary for dental implant

Needed implant bone graft

Contact us for a free estimate and consultation including 3D x ray.

Dr. Adams does full arch implant cases every day. He will do your entire case including the oral surgery and fitting the teeth. It is important to have an experienced implant surgeon because problems with implants can occur. We also offer sedation if you who would rather be put to sleep for implants.

dr gary adams

Dr Gary Adams

What are the types of bone graft procedures

Block bone graft with membrane. This is a bone graft (aka guided tissue regeneration) where there is not enough bone volume for an implant. In this situation, a procedure will need to be done to grow a volume of bone prior to surgically placing a dental implant. A necessary healing period for the bone graft of at least 3 months is necessary. After the graft healing period the implant can be installed after which there is an additional 2-3 month healing period prior to getting the implant tooth.

types of bone grafts

Socket preservation or bone graft of an extraction site with implant surgery. Bone graft near the time of extraction where a dental implant is placed at the time or around the time of tooth extraction. During this immediate implant surgery or delayed implant surgery, the implant is surgically placed along with a bone graft to fill in any holes in the bone the implant does not fill. In this later case, the implant and graft heal at the same time in about 2-3 months.

Ridge preservation bone graft with multiple extractions and implants. In cases where several teeth are being removed and several implants are being placed, grafting should always be performed. The grafts are performed to prevent tissue loss in the areas where teeth are removed and to help bone to grow properly around the implants. Complex full arch implants cases always requires some grafting to achieve optimal results.

Bone Grafts preserve bone and prevent infection

Grafts can be necessary in order to get extraction sites to heal properly. Grafting in extraction sites is also called socket preservation. Wisdom teeth and root canal extraction sites are notorious for having healing complications. Wisdom teeth are often times chronically infected prior to extraction and contain cysts. Wisdom teeth surgical sites can be difficult to reach and perform perfect surgical procedures. The sites are also difficult for people to keep clean and following post operative instructions can be difficult. Guided tissue regeneration techniques including bone grafts and platelet rich fibrin treatment are often used to help wisdom tooth extraction sites heal well. Basically when a tooth gets removed, a patient is sent home with a hole in their jaw bone (unless a graft is placed). A treatment such as PRF does a few things: 1) physically blocks gum tissue from growing into the jaw bone 2) helps protect the jawbone from bacterial infection. 3) provides building blocks to aid bone cells in growing new bone. When wisdom teeth extraction sites and other tooth extraction sockets are not managed properly, bone infections can persist for years. Many people believe chronic bone infections pose serious risk of medical problems.

Are Bone Grafts Needed for Implants?

It is true that many dentists will add bone grafting material to an area before placing a tooth implant. This is an ‘old school’ approach that is still commonly done. In some cases, it’s still necessary to do a graft.  The question is, “is there enough bone for placement of a new implant root?”  This question can be very subjective and case by case or even site by site in the same patient’s mouth.  For example, if a tooth does not have enough gum around it when they smile it will not look good.  If the same tooth is a front tooth, the site will need a graft for cosmetic dentistry reasons.  If the same tooth is a back tooth, the implant may not need anything because there are no cosmetic concerns.  In this later example, there may be adequate bone for an implant and no need for bone augmentation.

Can Bone Grafting be Avoided?

In many cases, however, we see bone grafting as unneeded and expensive procedure that greatly slows down the process of tooth replacement. Thanks to new types of dental implant materials that are available, all we need to work with, in order to place a dental implant, is 4 mm of bone width in many cases.

In cases where there is not enough bone to work with, in order to successfully place a tooth implant, it is possible in some cases for guided tissue regeneration be necessary to make a site in the jaw more suitable for tooth replacement with implants. In cases where grafting is necessary, we use PRF or platelet rich fibrin which helps bone and implants heal stronger and faster. PRF is derived from the patients own blood and is a holistic dental procedure.

PRF has many uses in Bone Grafting and Implant Surgery

Platelet rich fibrin is derived from patient blood draws. There are no added chemicals or other ingredients. The blood vials are placed in a centrifuge and spun for 13-15 minutes at 2700 – 3000 rpms. PRF is basically a mixture containing all the things necessary to prevent infections and rapidly heal and grow bone. Some of the things in PRF include platelets, white blood cells, stem cells, bone morphogenic protein and of course, fibrin. PRF can be used in combination with other graft products as a “super” bone graft of sorts. PRF can also be converted into a membrane and barrier to help hold bone graft materials.

prf bone grafts and implants

PRF in Dental Bone Grafting Video

Grafting before implants adds healing time

For patients who require bone grafting for teeth implants, placing Implants will take a little longer. In order to build up the jaw’s bone structure enough to support implants, part of the process involved may require waiting for a patient’s bone graft material to become properly integrated with the rest of their bone structure. This process may take months. So hopefully this sheds some light on if bone grafting is necessary for dental implants.

There are usually many possible approaches and strategies that an experienced implant dentist can take; for a more specific look at your case, please schedule a consultation with us.

Some root canal sites can be infected chronically. These sites can be very difficult to get to heal after extraction. Are root canals really necessary? Sometimes people experience regret about ever having gotten root canal procedures. Root canals can be necessary to save teeth or teeth can be removed and implants done instead.

What is a Dental Implant and How do They Work?

Posted on by Dr Adams

How do Dental Implants Work:

A dental implant is an artificial tooth root, a titanium or metal free zirconia root form that an implant specialist places into the jaw in order to replace a missing or bad tooth.

ceramic dental implant

The Best Way to replace a tooth is with a Dental Implant.

  1. Dental implant placement aka. Dental implant surgery.
  2. Placements of a connector called an abutment and a crown, bridge or denture (depending on how many teeth are being replaced).

During a first appointment, a titanium or zirconia implant is placed into the patient’s jaw. After that it’s necessary to wait a few weeks, as the patient’s bone grows in around the dental implant or new root. Once we’re sure that the dental implant has healed, aka “integrated”, during a second appointment, we replace the visible portion of the tooth with a permanent, ceramic crown. Or in the case of an implant bridge, there would be multiple implants and teeth secured by the implants.

What are the advantages of Implants?

  1. Permanent replacement for lost teeth. Implants should perform a lifetime. Look like teeth, feel like teeth and chew like teeth. Patients experience function similar to that of natural teeth.
  2. No bone loss. Removing teeth causes bone loss and sunken faces unless replaced with implants.
  3. Better chewing function means better diet and health. Patients who cannot chew food properly get constipated and do not get proper nutrients from food.
  4. Implants do not decay, get cavities or ever need root canals.
  5. very biocompatible. People do not react to implants they way they can to other dental materials.
  6. Implants rarely get infected and are not susceptible to gum disease like natural teeth
  7. dental implants do not require demolition of other teeth and are not connected to other natural teeth like natural tooth bridges.

Do Dental Implants hurt?

Dental implant surgery may cause very mild post-operative pain, but we rarely get many complaints about pain from implant surgery. Sometimes dental anxiety will cause a patient to need sedation for implant surgery, but it is not necessary for the procedure.

Does Dental Insurance pay for Dental Implants?

If you have dental implant coverage, yes. Dental implant insurance, however, is not included as part of every dental insurance plan. Even if your dental insurance plan does not cover dental implants, it might still be possible to get some reimbursement for dental implant expenses.

Many insurance policies exclude the surgical costs of dental implant placement but may cover some of the costs associated with the restorative phase. In this case the dental insurance will provide reimbursement for restoring the dental implant with a crown in a manner similar to that in which natural teeth are restored.


Can a full mouth of teeth be replaced in a day by Dental  Implants?

Traditional Dentures used to be the only option for patients who needed to replace all of their teeth. That’s not the case any more: Dental Implants can now be used to give you a new set of teeth that’s both permanent and beautiful.

Our dentists use six or more dental implants in order to securely anchor a full set of upper or lower teeth. And yes, this can all be done in a single visit at our implant office. This procedure can be done with or without sedation. A full mouth of implants can also be done with metal free zirconia dental implants too. Zirconia ceramic implants are tooth colored and do not conduct electricity.

Dentures are still an option that many patients choose. Traditional dentures sometimes had issues: They weren’t always comfortable and they didn’t always stay in place. Some denture wearers were afraid to smile, and couldn’t always eat their favorite foods. Implant-supported dentures or implant dentures have solved those problems. These removable dentures are securely held in place with a series of dental implants. they are much more secure than traditional dentures from years ago. The secure fit also means that the seam between gums and dentures remains hidden. You won’t be afraid to smile, in other words. While full-mouth dental implants are preferred by many patients, implant-supported implant denture scan be a cost effective solution in many cases. 

So this should answer, What is a dental implant?

Advantages of Snap-In Teeth vs Standard Dentures

Posted on by Dr Adams

If you’re tired of wearing poor fitting dentures or if you need to replace all your teeth with affordable implants, Snap-On dentures may be the way to go. This article look at the key advantages of Snap On dentures compared to regular dentures. For starters Snap-on teeth do not cover the palate. And you never need denture adhesive or glue.

regular denture vs implant denture

Advantages of Snap-On Teeth Compared to Regular Dentures

  1. Better Stability. Implant dentures do not move while eating and will not fall out of the mouth while talking
  2. Less food gets under the snap-in
  3. less bone loss because some of the lost teeth are replaced with implants. Placing Implants preserves jaw bone.
  4. Better Chewing function
  5. Improved nutrition and diet. Food is properly chewed. Patient absorbs nutrients from the food and does not get constipated.
  6. No more Fixadent or denture glue

What are Snap In Dentures Video

The Benefits of Snap On Teeth

Implant dentures aka implant over dentures, can be fabricated for either the upper or lower jaws. The advantage of dentures with Implants over conventional dentures is the ability to use the implants as anchors so the dentures do not move during eating or talking. How do denture implant attachments work? Dentures with implants also preserve the bone levels and maintain facial support thereby maintaining a more natural youthful smile. Options for implant dentures include four, five and six implants. The more implants the better the stability of the teeth. Cases with more implants have upgrade options to permanent implants such as full mouth implant bridges. Implant dentures is one example of how to replace a full set of teeth with dental implants

Different Options to Replace All Teeth with Implants Video:

Meet Dr. Adams

Dr Adams sees patients from Maryland, DC, Virginia, across the USA and abroad. Dr. Adams has successfully placed thousands of implants. Dr. Adams can handle cases involving one up to a full mouth of implants. Dr. Adams performs his own implant surgery and fits and places all his own implant teeth.

dr gary adams

Dr Gary Adams

Lower Implant Dentures Need at Least 2 implants but 4 is better:

The standard number of implants to do implant dentures for the lower jaw is two with two locator attachments stabilizing the denture. In some cases 4 implants and locators may be necessary to stabilize a lower set of teeth. Due to forces exerted by the tongue and cheeks during speaking or swallowing, a lower denture without implants is far more likely to come out while eating and talking. By contrast, dentures locked into implant attachments rarely come out during normal chewing, talking and daily activity.

Full Upper Set of Teeth Can be Replaced with 4 Implants

As many as six implants can be placed in the lower jaw, depending on the patients needs. As the number of implants increases, so does the stability of the denture, in addition to decreasing the amount of denture material in the patients mouth. With between four and six Dental Implants for the lower jaw, the patient has the options of a denture that is fixed into place full time or one that is stable during the day and removed at night. Another considerable permanent option with 4 or more implants is the All on 4 full arch implant bridge which can replace a full set of upper and lower teeth permanently with as few as 4 implants per jaw.

Upper Snap-On Teeth Needs 4 Implants

Similar options for the upper jaw are also available. Two implants for the upper jaw will dramatically improve the stability of an upper denture during function. It can be life changing for quality of life. When a patient opts for upper an upper denture that is retained by either four to six implants (depending on the clinical need), the area of the upper denture that covers the roof of the mouth can be removed from the denture. The main advantage being increased taste and a less bulky feel to the denture. Again, the implants provide stability for the new teeth so that the denture does not come out during speaking or eating.

Snap-In is the Least expensive Full Mouth Implant Technique

Implant over dentures offer the best increase to quality of life for people struggling with loose teeth falling out.  People with existing dentures that no longer stay in properly, and people are loosing bone with failing teeth. By utilizing implants for dentures, the patients bone is preserved, the facial proportions and dimensions are preserved (bringing a more natural and youthful look). Stabile teeth improves the ability to eat and speak properly (without worry of the dentures popping out).

The easiest way to determine if Implant Dentures are right for you is to come into the office for a complimentary exam to discuss your options with one of our excellent dental implant dentists.

dentures and false teeth

Advantages of Regular Dentures Compared to Snap On Teeth:

  1. Cost effective. Dentures are not expensive compared to implant tooth replacement options
  2. Can be made quickly and delivered the day of tooth removal.
  3. A great temporary option while implants are healing.
  4. Easing to refit after gum and bone healing.
  5. Look very good cosmetically because they can replace lost gum tissue and teeth.

Disadvantages of Regular Dentures:

  1. Thick and uncomfortable. Feels uncomfortable. Like you have a mouth full of plastic.
  2. Cannot be used in the event of a gag reflex. The denture will press on the roof of the mouth and cause the patient to gag.
  3. Can interfere with tasting food due to tongue interference and palatal coverage with acrylic plastic.
  4. Not tolerated by people with small mouths
  5. Not a good solution for people with sleep apnea because it takes up space in the mouth and can further close the upper airway.

Is there Pain During Dental Implant Procedures?

Posted on by Dr Adams

Does Dental Implant Surgery Cause Pain

Dental Implant Surgery is not a painful process.

The patient is given a local anesthetic prior to the start of Dental Implant placement so the patient does not feel pain during the procedure. For patients who are nervous or apprehensive, laughing gas (nitrous oxide), Oral Sedation Dentistry, and in more severe cases IV sedation dentistry can be utilized. In general, the Dental Implant placement does not take longer than fifteen – thirty minutes for the vast majority of cases, and most patients do not require Sedation Dentistry.

The local anesthesia continues to keep the patient comfortable for about two hours after the Dental Implant placement. The patient is encouraged to begin their medication prior to the anesthesia wearing off for a more comfortable rest of the day. Patients can expect to feel a slight dull ache for a day or two, which can be minimized with a cold compresses the same night of the dental implant surgery. Most patients who have Dental Implant Surgery, go to work the very same day, and day after the surgery. Your Implant Dentist will prescribe the appropriate medications to keep you comfortable before, during and after the procedure.

all on 4 dental implant

Permanent Implant Dentures vs Semi Permanent Implant Dentures

Posted on by Dr Adams

Permanent Implant Dentures are more Stable than Semi Permanent Dentures

When speaking about the types of Dental Implant Dentures, there is a distinction between Permanent Implant Dentures and Semi-Permanent Removable Implant Dentures. Semi Permanent Implant Dentures are also called Implant Dentures or Locator Dentures. Both Permanent Implant Dentures and Removable Implant Dentures, can be utilized for replacement teeth in either the upper or lower jaw. Semi Permanent Dentures are also called Implant Dentures or Dentures with Implants.

Permanent Implant Dentures most closely resemble natural teeth. These Fixed Dentures are permanently secured to four to six Dental Implants via a laboratory fabricated precision metal under-casting. A minimal amount of denture material is used to replicate the look of the gum tissue. This type of permanent denture allows for maximal space for the patients tongue. The advantage of choosing to replace teeth with a Permanent Implant Denture is the patient does not have to remove their teeth at night and there is virtually no chance of the denture dislodging during speaking or eating. The only drawback to this type of tooth replacement is the price, generally this the most expensive treatment option due to the amount of laboratory work required. Having said that, the patient never has to worry about taking their teeth out at night and maintenance required involves coming to their dentist every three – six months to have the Permanent Implant Dentures are also called All on 4 Dental Implants.

By contrast, removable Semi-Permanent Implant Dentures are a fantastic treatment option for patients looking to replace their teeth in either the upper or lower jaws. Removable Implant Dentures have the added advantage of securing to multiple Dental Implants, making them incredibly difficult to dislodge during speaking and eating. They are generally less expensive that Permanent Implant Dentures, due to less laboratory work required. Removable Implant Dentures have attachments built  into the denture that function like a ball and socket joint. The Implant Dentures clip into place and their strength can be adjusted based on the patients needs. Semi-Permanent Implant Dentures must be removed at night in order for proper cleaning and the attachments should be checked by your dentist every nine to twelve months.

Both Permanent Implant Dentures and removable Semi-Permanent Implant Dentures are great options for patients who struggle with loose or ill fitting dentures, or patients who are looking to restore their mouths without worry of dentures that fly out when eating or speaking. Stop by our office for your complimentary consultation with one of our expert dentists to see if either Permanent Implant Dentures or Semi-Permanent Removable Dentures are right for you.

What is Bone Graft Surgery for Teeth Implants?

Posted on by Dr Adams

What is Bone Graft Surgery?

Bone graft surgery is a procedure to help bone grow or heal where there is bone damage or deficiency. Bone grafting is sometimes called guided tissue regeneration. Whether or not you need bone grafting for dental implants and extractions comes down to many factors.

dental implants bone loss

Bone Grafting may be Needed in the Following Situations:

  1. Teeth Extraction sites to help bone grow back properly into the bony socket. Also called socket preservation. Socket preservation helps prevent long term bone loss, and helps grow bone for dental implants to be placed where teeth have been extracted.
  2. Infections caused by failed Root Canals
  3. Implant surgery to help grow bone around implants. Especially helps grow bone when implants are placed at the same time as tooth removal. This is very common when doing full mouth implant cases where several teeth are being removed and implants are being placed at the same time
  4. Grow bone in areas where there is not enough bone for implants
  5. Grow bone to improve gum health and cosmetics around existing teeth and implants.
  6. Wisdom teeth extraction sites
  7. Grow bone in atrophied sinuses

How is Bone Grafting done with Dental Implant Surgery?

The most common reason to perform bone graft procedures is for dental implant surgery. There are two categories: The first is placing the bone graft where implants are done after a healing period. That is bone graft surgery and delayed dental implant placement. This kind of bone graft is considered pre-surgical ridge augmentation. Generally, this is done when the area to be grafted has had an extensive infection which has destroyed the native bone and compromised the success of placing a dental implant. In this situation, the infected area is cleaned, and new bone is added (this acts as a scaffold to allow the persons body to replace it with their own natural bone). The site is revisited for implant surgery after 3-6 months of healing.

block bone graft

Bone Loss Occurs After Tooth Loss

In the absence of infection, the area can undergo bone loss simply based off of time without a tooth present. The teeth hold the bone levels and without a tooth present, the jaw bones can become atrophied over time. In this event, pre-surgical ridge augmentation or bone graft surgery may be necessary prior to getting dental implants, as described above.

Immediate Implant Surgery Often Requires Bone Grafting

The second kind of bone graft surgery is when the bone graft is done at the time of implant placement. This type of bone graft is usually done when the site is 75% of the way intact, but with only one portion of the bone in question. The implant is placed and bone graft is added to the area similarly to the way potting soil is added when re-potting a plant. The newly added bone heals around the dental implant and the original defect is repaired.

What Are the Different Ways to Do Dental Implant Surgery?

Posted on by Dr Adams

Same Day Immediate Implant vs After Grafting and Healing

By Dr. Gary Adams who has successfully done thousands of dental implants in Burtonsville near Silver Spring, Clarksville and Columbia Maryland. Dr Adams does single implants and full mouth dental implant surgery.

Gary Adams DDS Holistic Dentist

Single tooth replacement with a Dental Implant procedure can be in one of two Different Ways:

What is Immediate Dental Implant Surgery:

Immediate implant is where a bad tooth is taken out and an implant is put into the jawbone on the same day. The situation is where there is a bad tooth (the one that needs to be removed) is currently occupying the space where a tooth replacement needs to go. This is opposed to where there is no tooth present and a new tooth is desired.

Immediate implants is often done when replacing a full set of teeth with implants. A full upper or lower set of teeth can be replace with implants in different ways. Some implant teeth are permanent and others such as implant dentures are removable teeth. The implant surgeon will remove all the bad teeth, put in new implants and do any necessary bone grafting at the same time. Usually, the dentist puts in a new set of teeth that the patient will use during the healing period.

same day implant

What is the advantage of immediate implant surgery?

  1. Save time
  2. Only get one surgical procedure when a tooth is removed and an implant is done during the same procedure.
  3. Better gum and bone healing – gum tissue and bone tissue do not collapse into an extraction site when implant surgery is done with tooth extraction
  4. Better gum and bone healing – the body is ready to heal when a tooth is removed. The healing is typically better and can be stronger when a implant is done with the extraction.
  5. Better cosmetic and more natural looking results. If gum and bone are not lost, a tooth implant looks more like a natural tooth with proper gum proportions around the tooth.
  6. Shorter time without a tooth. How long would you want to go without your front tooth? Or any tooth for that matter?

For cases of Dental Anxiety it may be necessary to have sedation dentistry, but it is not required.  We offer IV sedation. Anesthesia can be achieved with a local anesthesia just like what is used for a dental filling.  Laughing gas aka NO2 can also be used as a twilight sedative for implant surgery.

Delayed Dental Implant Surgery vs Immediate

In the event the dental implant is unable to be placed, due to lack of bone support or a large jaw infection, sometimes the proper clinical decision is to do a bone graft, let the body heal and “delay” the implant surgery to a later date. In some cases a healing period may be necessary to achieve optimal results. In general, the body can take up to 6 months for this to happen, although it is often times a shorter wait.

Delayed placement, or placing an implant where there is currently no tooth, is a usually a straight-forward procedure.

How Long does it Take to get a tooth replaced with Dental Implants?

  1. The first appointment for a dental implant, whether taking the tooth out and placing the implant or simply placing the implant can be conceptualized as replacing the root of the tooth first. The body is allowed to heal for roughly 2-3 months.
  2. During the second appointment, an impression of the surrounding teeth and gums in addition to the dental implant is taken for the lab to craft a new crown (the portion of the tooth one sees.) This appointment does not require dental anesthesia.
  3. The third and final appointment, roughly 1-2 weeks later, the final dental implant crown is delivered to the patient along with a connector called an abutment. The patient’s bite is checked and the esthetics are verified. Some minor adjustments may be necessary but in general, no dental anesthesia is required.

There are also other varieties of the dental implant procedure for other scenarios including replacing multiple teeth at a time or using implants to secure dentures.

Other Popular Blog Posts:

Other popular pages:

Call Now Button