Do you have enough bone for a dental implant?




Losing a tooth can be down to a numbers of factors. Sometimes the chain of events leading to the end of the road was initiated right under your nose, you just didn’t realise it at the time.

Knowing how the hopeless tooth is removed is of key importance.

More than 20 years ago, the old-fashioned way of teaching how to remove a tooth seems quite primitive now. But the goal posts have moved. The everyday solutions have changed, and our techniques have had to evolve. 

The bone present around the tooth that has its days numbered is the key. The focus should be, ‘Can we preserve the surrounding anatomy?’.

Analogy: If you fill a bucket with water, the water is contained. If one side of the bucket is missing, then the water drains away. It is the ability of the water/ blood in this case to be retained in the bucket/socket that allows our bone forming cells (osteoblasts) to work their magic.

The careful strategic sectioning of the tooth without damaging the surrounding bone is the most important factor in good pain-free healing and achieving a good volume of bone to work with at the next stage of the rehabilitation.

3D X-ray imaging is now routine in any modern-day dental surgery and can be used to plan an extraction prior to commencement of treatment and highlight any potential complications that could occur. This combined with dexterity and patience will result in a positive outcome for all involved.

Additionally, a machine called a peizotome can be used to ultrasonically remove tooth and bone in an ultra-conservative fashion to promote healing postoperatively.

Now the term ‘bone graft’ is used in dentistry more commonly than ever before. But what does this actually mean? What is it made of?

Sometimes due to infection or a difficult tooth shape it is not possible to retain all the bone that surrounds the tooth. After the tooth is removed, a defect may be unavoidable. Sometimes there is not enough height of bone to place the appropriate size of implant for that particular tooth position.

There are four main types of bone grafting material. All four will ultimately act as a scaffolding for your own bone to fill in the spaces. Synthetic (alloplast); bovine (xenograft) – this is cow bone, the most common used in Australia is called Bio-Oss; your own bone (autograft) – usually from another location in your mouth; someone else’s bone (allograft).

One or sometimes a combination of these four can be used at the time of the extraction or later on, at the time of implant placement.

The correct planning and discussion with you prior to the problematic tooth being removed cannot be underestimated.

Shore Dental
9953 1124
2 Waters Rd, Neutral Bay

Dr James Cooke and Dr Ben Wilcox are co-owners of
Shore Dental, a privately owned and operated general
dental practice in Neutral Bay. Shore Dental has
been treating the North Shore community for over 40
years. For more information, phone 9953 1124 or

Shore Dental

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