Burbank Implant Dentist on Extraction Defects…Relation to Dental Implants and Bone Grafts

Burbank Implant Dentist on Extraction Defects…Relation to Dental Implants and Bone Grafts

Burbank Implant Dentist on Extraction Defects…Relation to Dental Implants and Bone Grafts

Teeth are removed for several reasons, including periodontal (gum) disease, extreme decay, and for orthodontic reasons.  Once a tooth is removed, the shape of the ridge (i.e., the supporting bone and gum in which the tooth was situated and retained) changes. If there has been extensive bone loss, or if the tooth needed to be surgically removed (bone had to be cut away to gain access to the area), the change will be more dramatic. The ridge shrinks, collapses into itself, and over time decreases in width and height. As more time passes after the extraction, the more change occurs.

This is an extraction site defect. Look how skinny the bone is compared to the image next to it!

Lr
Lr-----

The extraction site defect presents a problem when the area is to be restored with an implant.

When the ridge architecture has significantly changed, the replacement tooth will have to deviate from the ideal shape. This could easily make the area more difficult to keep clean, difficult to restore, and cosmetically quite unsightly.

Perhaps the cosmetics may not matter to you when there is a back tooth being replaced one that is not visible when you speak or smile. An extraction site defect in an area visible when you speak or smile will create a severe esthetic problem.  The more the ridge has changed, the more your tooth will need to be either longer, wider, or fatter in order to fill up the extraction site. If you have a smile line that shows the tooth or gumline, the replacement tooth will be very obviously misshaped. It will never look right and will be a cosmetic failure.

Here is a dental implant on a patient from Burbank that I did:

missing tooth
2004
front tooth dental implant --Dr. Ramsey Amin -Burbank
2009

It is clear that for the dental implant replacement tooth to have a normal appearance, the extraction site must be rebuilt. The closer it can be made to the ideal, the better the replacement tooth will appear.  The site (or ridge as it is really named) can be restored through gum tissue grafting and/or bone grafting.

If the ridge needs only a small amount of augmentation, only soft tissue procedures may be needed. If there is a large defect, the underlying supporting bone will have to be replaced as well. If the site is especially visible or needs an extensive amount of rebuilding, more than one augmentation procedure may be necessary. My goal is to make the replacement tooth appear to be growing out of the extraction site, not merely lying against the gum.

If a dental implant is to be placed to act as an anchor for the replacement tooth, the extraction site must have enough bone thickness and height to properly surround the implant.

Here is an example of a 20 year old girl from Los Angeles that I had to do an onlay bone graft and gum graft to fill the major bone defect from a roller-skating accident.

IMG_0870gg

Major bone loss.


IMG_7607

After a onlay block bone graft, implant and custom Abutment. Note how there is no longer a depression of bone after the bone is built back up.


DSC_0017_4

Final result. Restored Dental Implant!


As you can see, extraction site bone or gum defects are really important.  Choose the right dentist for your implant!

Ramsey Amin, DDS

4 Comments

  1. Hi James,
    No, the implant and the bone graft were done on separate occasions. If the bone graft is large, typically it is better to separate the procedures.
    Ramsey A. Amin, D.D.S., D.A.B.O.I.
    Diplomate of the American Board of Oral Implantology /Implant Dentistry
    Fellow-American Academy of Implant Dentistry

    June 25, 2011 at 10:40 pm Reply
  2. James

    Dr. Amin,
    Thanks for the article above. It was very informative.
    In a case such as the one with the 20 year old above, was the implant placed the same day that the onlay bone graft was performed? How typical is this?
    Thanks

    June 23, 2011 at 1:37 pm Reply
  3. This is a very broad question since I can not examine you personally.
    If the bone is that skinny you may be looking at block grafting to restore the width of bone. Make sure to see somebody VERY good since this is the most difficult area in the mouth to do this.
    See this post:
    http://www.dentalimplantdentistryblog.com/2009/04/what-is-a-block-bone-graft-associated-with-dental-implants-video.html
    Because of the advanced bone loss you are probably in the $9000 range to restore the area to completion.
    I hope this helps!
    Dr. Ramsey Amin

    January 3, 2010 at 8:16 am Reply
  4. Mona

    Dr. Amin,
    First of all thanks for posting your very knowledgeable information here. It happened just i was trying to dig out some info on implants and its procedure on the internet and discovered your web here.
    My lower jaw’s 2 molars (on each sides) are missing. And its been several years so i’d say my case would be very similar to the patient on 1st pics. Probably bone grafting is needed. In such cases what would be the cost of the implants (including the bone grafting procedure, specifically autografting maybe?)?what would be the complications of autografting? would it be safe and painful etc…
    thanks in advance.
    looking forward to your reply.

    January 1, 2010 at 12:07 pm Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!