My snap-on denture bone graft failed

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I agreed to two dental implants for a lower snap-on denture. My dentist said my jawbone had shrunk from having all my teeth missing for 15 years, so he needed to do bone grafting. We waited two months, and then during my second follow-up appointment, my dentist said that the bone graft failed. I am disappointed that I must start the process all over. I know my dentist has placed implants for at least a hundred patients. Although I didn’t think about it before, I wonder if he is not is good with bone grafting. Although I like my dentist, I hate the thought of another bone graft failure. I don’t know what to ask you, but I’m nervous and want some insight into the issue. – Thank you. Isaac from TN

Hello, Isaac,

Thank you for contacting our office.

We understand your concern and hesitation. Although many dentists have implant training and place implants frequently, fewer dentists have lots of bone grafting experience.

It is good that your dentist is upfront with you and did not try to place your implants anyway. Any implant denture—including a snap-on denture—requires good bone support. Otherwise, both the graft and implant will fail.

What to Do After Bone Graft Failure

Diagram of a snap-on denture. The denture is hovering above the jawbone that has two dental implants in it.

Healthy bone grafting will help secure your affordable implant denture

If you have experienced bone graft failure and are hesitant about letting your dentist try again, consider these options:

  • Talk to your dentist about your concerns – It may be easier to decide what to do if you ask your dentist how much bone grafting experience he has acquired over the years. You can also ask if your dentist knows what caused the bone grafting failure and what he will to do prevent it from recurring.
  • Ask for a referral – You can ask your dentist to refer you to a periodontist (implant specialist) or an oral surgeon for grafting and implant placement.
  • Get a second opinion – You can get a second opinion from a dentist with advanced implantology training who regularly performs bone grafting procedures.

Each time you experience bone graft failure, you must wait for the grafting sites to heal before another attempt. Weigh the pros and cons and do what you think is best for your oral health. Best wishes for a resolution and being able to enjoy your new implant denture.

Steven Brooksher, DDS is a cosmetic and implant dentist in Baton Rouge, LA. Read about his credentials and visit his smile gallery. It will help you determine what to look for in a dentist in your area.

 

Shouldn’t a sinus perforation have healed by now?

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In June, my dentist extracted two teeth, and I’m waiting to get dental implants. For one upper right tooth, my dentist said he could see into my sinuses. He prescribed antibiotics for me to take for a week. I didn’t have any special instructions other than taking antibiotics. My other tooth healed fine, but the sinus perforations still isn’t closed. My primary care doctor prescribed more antibiotics. I have a continual headache and a low-grade fever. How long does it take for a sinus perforation to heal? It’s going to be months before I can get dental implants. I think I need a second opinion. Am I going to need an oral surgeon or an ENT doctor to close the perforation? Thanks. Clay

Clay,

It seems that your dentist doesn’t know how to handle a perforation that doesn’t heal. It’s wise to get a second opinion.

How Long Will Does It Take for a Sinus Perforation to Heal?

If your sinus is perforated from tooth extraction, the tissue normally heals within four to six weeks. Bone grafting is often needed, though, and it will heal in about six months. If a perforation from an extraction doesn’t heal, there are several possible causes. Two possibilities include:

  • A root tip from the tooth is pushed into the sinus
  • A bone fragment remains

Has your dentist or primary doctor sent you or an x-ray of your sinus? It’s best to visit an otolaryngologist (ear, nose, throat (ENT) specialist) who will request an x-ray, see I something if blocking the sinus, remove it, and ensure the infection goes way by prescribing more antibiotics.

If there is a bone fragment in your sinus, it’s good that your dentist didn’t close the perforation. The irritation from the fragment would cause ongoing infection and fluid drainage into your mouth and nose.

Closing a Sinus Perforation

Diagram of the phases of a dental implant for a comparison to a partial denture.

After sinus perforation and bone grafting heal, you can receive dental implants

How is a sinus perforation closed? Although your doctor might have a specific technique, the procedure includes steps like these.

  • Place collagen plugs or another resorbable membrane in the tooth socket
  • Gently place bone graft around the sides
  • Secure the bone graft and protect the site with another collagen plug or resorbable membrane
  • Stitch the membrane over the graft to keep it in place

After closing the perforation, a specialist will prescribe antibiotics, and based on the severity of your infection, tell you how long to take them. You’ll have follow-up appointments to ensure the area heals well.

Tell your ENT doctor about your plans for dental implants to replace your two missing teeth. The doctor and your implant dentist can discuss the optimal time for implant placement. Both the perforation and bone graft must heal before you receive dental implants. Otherwise, the implant and your jawbone won’t fuse, and the implants will fail. Be patient.

 

Steven Brooksher, DDS, a Baton Rouge dentist and Fellow of the International Congress of Oral Implantologists, sponsors this post.