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Bone graft quality?

Last Updated: Aug 17, 2016

I am a 60 year old male patient from Asia. This is the first time I am going to get dental implants. I have always done well with root canals and bridges. Recently, I had to get a pre-molar and a wisdom tooth extracted and now left with no choice but to get a couple of implants on the upper right side of my jaw. I got sinus lift surgery done with bone graft in January 2016. I was advised to have implants done after 4 months. However, I am unable to go back to the same oral surgeon for review due to relocation. I got an OPG taken. If possible, I would like input on the bone graft quality. I see a kind of a void above the new bone below the sinus. I am wondering if this is going to pose an issue with new implant? It is not perfectly filled with bone. I am not having any problems. Can I still get two or three implants at the site of my new bone graft? What are recommended types and sizes of the implants? Thanking you in advance for your kind advice. I am attaching a portion of the OPG showing the new bone graft area.

![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2016/08/aa_upperRT.jpg)4 months after sinus lift bone graft

5 Comments on Bone graft quality?

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Irbad Chowdhury DMD, FICO

8/18/2016

The posterior void (distal) is just the ungrafted area of the sinus, which is normal. Bone quality looks good but will be determined at time of surgery. 2 to 3 implants looks warranted in this area. Good luck!

8/19/2016

Thank you! sir, for providing your input. It's comforting to note that the void areas are not of major concern. Three implants is what I am considering for sure. I read many sinus perforation cases due to height of implants used or there may have been other causes. I just want to better prepare to make informed decision. Therefore, if I can get advice on what should be the height of each of the three implants. it would be great. Should they vary according to height of the bone graft below the sinus. So any feedback is appreciated. Where can I get more information on types of implants and what is most popular type?

Peter Fairbairn

8/18/2016

As most sinus grafts involve HA ..... only a core sample can asses the "Bone" quality and host bone may be more scarce than appears ... In a world where all notions of success are measured in only quantity ...... maybe true quality should be a more valued measure of case success Regards Peter

8/19/2016

Thank you so much! Does the quality of bone depend on the graft material used? I was told that synthetic material was used for my bone graft. I am guessing that quality of bone depends more on our body's own characteristics.

Peter Fairbairn

8/20/2016

Yes and yes your bodies physiology to regenerate bone varies and ability breakdown the graft material ( it also depends on this , its type etc ) As to Quality the most important Systemic review in Dental journals by HL Chan , HL Wang et al in the JOMI , Volume 28 , no 3 .2013 shows that Synthetics have significantly more new host bone ( up to 23 % more) than the more dense donor materials such as Xenografts ( up to 22 % less ) than adjacent bone Regards Peter

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