Can I Get Dental Implants Without Having Any Bone? Video

Dental implants without bone? How can that be done? If you don’t have any bone left at all, and you’ve been told there’s just not enough bone to get implants, what are your choices? In my office, I treat the most extreme of extreme patients. So when the bone is missing, you have two options.

One is to use the good bone that’s left. It may surprise you to find out that there is good bone available. And the second option is to rebuild the bone through bone grafting also known as bone rebuilding. In this video, you’ll discover the details for both options for how you can get dental implants without having any bone.

For more details watch the video below and if you have questions or comments, please post them below and subscribe to my channel to get more information about dental implants.

Dental implants without bone, how can that be done?

Video transcript lightly edited for easier readability.

What if you don’t have any bone at all, you’ve been told there’s just not enough bone for this procedure? In my office, I treat the most extreme of extreme patients. So when the bone is missing, you basically have two different options. One is to utilize the good bone that’s left and that may not always be in the area that you think. And the second option is to rebuild the bone back through bone grafting, bone rebuilding. So let’s go with the first option of the concept of using the good bone that you have.

Some people have really tiny bone, they’ve lost all their upper and lower teeth and their face has sunken in and everything is just gone. Now the only way to really build back the bone with all missing teeth would be to take bone from your hip at the hospital and stick it in your mouth, and so doing hip grafting. A better option and I’ve written on this before, is called bone leveling and using the good bone that you have. It may be in remote locations. So let’s talk about the upper jaw.

If you have no bone, implants with no bone in the upper jaw, the solution, oftentimes is what’s called a zygomatic implant and I’ll post some links to that here as well. Zygomatic implants come this way. They are long, about maybe 45 millimeters long. They go into the good bone of the cheekbone. That’s very hard and you can put implants through the mouth and connect those up very easily. And again, I won’t belabor that point. I’ll put some links up for zygomatic implants.

Other options are what’s called pterygoid implants. Those go in different spots as well. Now instead of rebuilding the bone, they go back where the wisdom teeth used to be and where it looks like there’s no bone. 99% of dentists will not even know what that implant is or how it is placed or where it goes or they’ve never even heard of it. The same thing with zygomatic implants. It’s not a very common thing because it’s more difficult.

The other option in the upper jaw, so we’re talking about pterygoid implants, zygomatic implants and also implants that go into the base of the nose or they go trans sinus, they go through the sinus and into basically the side portion of the nose called the piriform rim. Those are all things in my practice I do on a daily basis to treat the patients that have no bone and not only do they have to have this surgery done, but they get teeth on the same day or by the very next day. It’s not wait and wait and wait for the bone to get rebuilt and then come back and have 50 appointments and two years later to finally get teeth. No, you get teeth the very next day and it’s an awesome procedure.

On the lower jaw, again, there’s usually some remaining bone in this area kind of in-between where the nerves end on each side. Even if it’s as thin as my pinky, I can generally still put implants in and make a fixed bridge. Sometimes I have to do alternatives like I need to move the nerve called the mental foramen. Moving the nerve is called repositioning of the nerve so that it’s in the way sometimes, those called the wires of the jaw, run through each side about right here. Sometimes I have to move them out of the way to put implants into the right spot. So these are obviously more extreme dealing with patients that have no bone at all but still want implants to stay in place. Not a snap-on overdenture that would have to come in and out.

So nerve repositioning on the bottom jaw or moving that little hole we call the mental foramen, move it out of the way so that implants can be put into the right spot. Sometimes managing the lower jaw with another option called a subperiosteal implant. It’s an implant that goes over the bone. It doesn’t go in the bone. It’s an older technique, but we’ve seen some resurgence with it using different technologies for 3D printing and milling and titanium. Other things called blade implants that I use for the no bone patient that has nothing at all. Those options oftentimes are much better and much more cost-effective, requiring a lot less surgery than rebuilding a massive amount of bone, especially for full mouth replacement.

In smaller segments, rebuilding bone if you’re missing a section of teeth here or a section of teeth over here or one tooth, then certainly building bone by taking bone from the jaw over here, transplanting it up over here. Sometimes it’s ground up and placed there. Sometimes it is powdered or synthetic bone or usually bone from a tissue donor is planted underneath that membrane. It’s tucked under the gum and bone is placed, a membrane is placed to hold it all in and it’s allowed to heal for several months. So even in spaces that have no bone at all, you’ve been told you’re missing a front tooth, either the lower teeth or the back one, that bone can be rebuilt, the nerves can be moved. Sometimes it just takes more extreme measures, building a cage with titanium to hold in a bone graft, to sometimes move a segment of bone, not even detach it, meaning leave it attached to the gum and move it. We call that a vascularized pedicle bone flap.

I don’t mean to be too technical, what I’m trying to do is give you a hope that you can certainly have implants if you’ve been told there’s no bone. You just need to do your due diligence and see a provider and that’s all they do and that’s what they’ve done for a long time. This is something that’s very common in my practice. I treat the patient that has really extreme needs. Of course, I treat normal missing teeth and teeth that are about to be lost, but having no bone requires definitely a certain expert level of treatment to be done.

So I’ll post some links so you can click around and begin to learn a little bit about it but have hope. You can have dental implants for sure. It may just cost a little bit more. It may take a little bit more time, sometimes a lot less time than you thought, but it is certainly doable. Thanks for watching. 

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

26 thoughts on “Can I Get Dental Implants Without Having Any Bone? Video”

  1. Hello Dr. Amin, I had a full upper implant replacement about 3 years ago. My question is the doctor/surgeon placed the front implants back so far that I have a partial plate over the roof of my mouth. This causes me to have a hard time speaking properly. He said my bone there was bad so he had to move the implants back. I was very upset because I feel like he should have known this prior to surgery and discussed it with me prior to just doing it. This brings me to this question, is there a possibility of being able to reposition the front 2 implants without such a huge cost, it cost me over $30k to get this done.

    Reply
  2. Hello,

    I just came from the dentist, she said I need 2 or 3 teeth pulled, but I have to wait until my swelling goes down from abscess tooth. Should I go to a Periodontist for a 2nd opinion before getting these teeth pulled? Also she told me I have advanced Perio disease and there is nothing I can do regarding getting implants, and will eventually have to pull out most teeth, Im only 48 yrs old. I ve been crying all day, but your video has given me hope. Im in the las Vegas area. Please advise if I should get my teeth pulled then come see you, or should I put a hold on that and get a 2nd opinion first. I’m so nervous, please advise.
    Thank you.

    Reply
    • There certainly is hope. In fact I just treated two women in their 40s just this week for severe bone loss. I know it’s troubling and very disturbing to think that you might be losing your teeth. You are welcome to come in and see me and my team. We will take good care of you. 😇

      Reply
  3. Hello I’m 20 years old have been missing tooth #8 for years now . I went to a dental surgeon and was told that I don’t have any bone left in that area and that a bone graft would fail. The surgeon recommended I do Invisalign treatment if I want to straighten my teeth and then a Maryland bridge after. Should I get a second opinion? I thought the point of bone grafting was to rebuild severe boner. Thank you.

    Reply
  4. Hello I’m 20 years old have been missing tooth #8 for years. I went to a dental surgeon and was told that I don’t have any bone left in that area and that a bone graft would fail. The surgeon recommended I do Invisalign treatment if I want to straighten my teeth and then a Maryland bridge after. Should I get a second opinion? I thought the point of bone grafting was to rebuild severe bone loss.

    Reply
  5. Hi Dr Amin
    I have few questions to ask from you.
    I was diagnosed with Rheumatoid Arthritis for more than 20 years and on many years of medications.
    Am I candidate for tooth implant?

    Reply
    • Yes – with some special precautions.

      I would need to know a lot more about you than just rheumatoid arthritis.

      Please feel free to be as detailed as you would like on this Public
      Forum.

      Age, medical conditions, medications, allergies, surgeries, etc

      Also I need to know the extent of dental surgery you are looking for. Is it one tooth or a full mouth with zygomatic dental implants?

      Reply
  6. Hi I went to the dentist today and my dentist told me if I was to get my last 3 teeth on my upper right side pulled…it would take 3-weeks to heal, come back in get fitted and come back in maybe in the coming weeks. I was truly saddened when she told me I have a mask I can wear and had no means of giving me anything to support my mouth as far as eating. I can’t get metal partials because with no teeth on my upper right side what will it hook onto. I am sooooo tired of false hope from dentist nowadays. I am looking around getting other options. I want to get bone-grafting done, but I was also thinking of getting bridges as I read you really don’t need any bone-grafting done. Is it true? My second to front buck tooth is pushing on it and is sort hanging out a bit. My appearance is sooooo important because I always want the best. I never had a cigarette and drugs of no kind. Periodontist is what I have and once those 3-teeth are gone basically the dentist says its gone. I go on wondering about my looks just stressing how will it get done…I know procedures are timed! How can’t your own dentist tell you wait 3-weeks with no back up plan of how I am suppose to eat. She goes…eat on my left side and that was all I got! I will not dismiss my teeth until I get a better dentist/alternative to my issue.

    Reply
    • Hi Marcy – i’m a bit unclear on what you’re asking. I think you’re asking when can you get fitted for a denture? Usually it’s best to wait 6 to 8 weeks after extractions for that.

      If you do have one good side to chew on then that is OK. It’s a short term sacrifice for a long-term benefit. Ideally you have implants put in at the same time that you had the teeth extracted. That saves time and money. About 90% of my cases are done that way but this is a very advanced procedure.

      It’s always important to have a back up plan.

      Bridges are good as long as the anchor teeth are in good shape. They do better in the front of the mouth then they do in the back of the mouth.

      Maybe consider seeing a true dental implant specialist rather than just a regular dentist?
      🤷🏼‍♂️

      Reply
  7. Hello. I’m 19 years old and I recently got a bone and tissue graft in the #8 area. I got #8 extracted when I was 12 which led to a lot of bone deficiency. Anyways, I am currently going through my initial recovery and so far I don’t have any pain, swelling, or bleeding. However, one of my main struggles is that my mouth feels so restricted. I can barely open my mouth and it hurts when I smile. Is my mouth going to feel like this during my months of healing?

    Reply
    • They probably borrowed a little bit of your lip/cheek to cover over the improved bone volume. This is generally corrected at the time the implant is placed. The gum can be repositioned so that it does not feel so tight. I have done this many times over the last 21 years.

      Reply
  8. Hello. I’m 19 years old and I recently got a bone and tissue graft in the #8 area. I got #8 extracted when I was 12 which led to a lot of bone deficiency. Anyways, I am currently going through my initial recovery and so far I don’t have any pain, swelling, or bleeding. However, one of my main struggles is that my mouth feels so restricted. I can barely open my mouth and it hurts when I smile. Is my mouth going to feel like this during my months of healing?

    Reply
    • They probably borrowed a little bit of your lip/cheek to cover over the improved bone volume. This is generally corrected at the time the implant is placed. The gum can be repositioned so that it does not feel so tight. I have done this many times over the last 21 years.

      Reply
  9. Hello, I’m 19 years old and I recently got a bone and tissue graft done in area #8. When I was 12, #8 was extracted which is why I had a lot of bone deficiency. After my surgery, I didn’t really experience any pain, swelling, or bleeding. However, one of my main struggles is how restricting my mouth feels. I can’t really open my mouth or lip and it hurts when I smile or laugh. Is my mouth going to feel like this during my months of healing and recovery?

    Reply
    • They probably borrowed a little bit of your lip/cheek to cover over the improved bone volume.

      This is generally corrected at the time the implant is placed. The gum can be repositioned so that it does not feel so tight.

      I have done this many times over the last 21 years.

      Reply
  10. Hello, I’m 19 years old and I recently got a bone and tissue graft done in area #8. When I was 12, #8 was extracted which is why I had a lot of bone deficiency. After my surgery, I didn’t really experience any pain, swelling, or bleeding. However, one of my main struggles is how restricting my mouth feels. I can’t really open my mouth or lip and it hurts when I smile or laugh. Is my mouth going to feel like this during my months of healing and recovery?

    Reply
  11. Do you have any associates or do you know of any board certified dental implant specialists in Western Pa; the county of Indiana, Pa, or the Pittsburgh area?

    Reply
    • Hmm. Zygomatic and pterygoid implants are highly specialized implants not mastered by many.

      I can’t think of someone off the top of my head. Sorry 😞

      Reply

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