Bone Loss over the Life of a Dental Implant: Open Discussion

Bone loss occurs through out the life of a dental implant no matter what we do to it (eg. platform switching, nano surface technology). This is more so if the implant has been in the mouth for over 10- 15 years. Disease processes will exacerbate the rate of bone loss. Bone around an implant does not remodel in the same way as a natural tooth and cannot response in a way that a tooth does. The presence of periodontal ligament is vital to the long term maintenance of the bony ridge. How do we incorporate these factors into our long term treatment planning? Please leave your comments below.

4 thoughts on “Bone Loss over the Life of a Dental Implant: Open Discussion

  1. John Kong, DDS says:

    According to Albrecktsson’s established criteria for implant success, marginal boneloss post-loading should be less than 1.5mm the 1st year and on-going annual boneloss less than 0.2mm. He probably based this mostly on the earlier and still crappy NobelBiocare/Branemark implants.
    To maintain the marginal bone, the type of implant, sound surgical and prosthetic protocols have significant impact.

    I like the classic Straumann Standard tissue-level implants with the 2.8mm smooth collar supra-osseous for posterior teeth.
    Platform switch with morse-taper connection implant (Astra) for anterior teeth.
    Angulation of the implant for axial load and depth of the implant (not so deep during immediates) are also significant. These combinations give me on average better results interms of maintenance of marginal bone and certainly within the limits of Albrecktsson’s classic criteria for implant success.

    Sloppy prosthetics like cement retention, open margins, deeply placed abutment margins, crappy crowns, excessive occlusal load, etc. also contribute to marginal boneloss overtime.

  2. peter fairbairn says:

    Not always so , whilst there are numerous reasons for possible bone loss over a period of time it is not an accepted fact . A group of us have noticed a consistent gain in bone height over the first few years of loading when using synthetic grafts and placing at the time of grafting even in cases where an adjacent implant in solid natural bone may show a small loss .
    There is so much we do not know it makes generalising any fact impossible.
    This has been noted over hundreds of cases so interesting and I have shown it often, is it worth doing some research , probably not , just more confusion as the biggest variable patient physiology is unpredictable
    Regards
    Peter

  3. Robert J. Miller says:

    I have to strongly agree with Peter on this one. While we see bone loss on almost all of the older implant designs, I have been astounded by the OPPOSITE effect on some new implant designs. While implants that are placed at crest may show varying positions of bone levels, I am amazed at the increase in bone levels where implants are deliberately placed supracrestal. We measure these cases periodically over several years and find that this phenomenon continues throughout this time, including bone growing up to the abutment. There is a common thread on this one: a bioactive implant surface, low torque placement, low abutment microleakage, and medialized platform. The concept that we must accept crestal bone remodeling (net bone LOSS) is nothing more than mythology. Old paradigms do die hard.
    RJM

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Questions, Surgical.
Bookmark Bone Loss over the Life of a Dental Implant: Open Discussion

Videos to Watch:

Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!
Implantoplasty to Treat Peri-implantitis

This video shows the use of the Implantoplasty technique to treat peri-implantits. Granulation tissue and[...]

9 Comments

Watch Now!
Placement of Implant Using EZ Devices

This video demonstrates the placement of a dental implant in the upper jaw using the[...]

Watch Now!
BonePen: Improve Positioning of Implants

A short video demonstrating close up the use of the BonePen Kit, a set of[...]

Watch Now!
Vertical and Horizontal Bone Augmentation with Khoury Bone Plates

This video shows a way to utilize thin autogenous bone plates to create stunning bone.[...]

4 Comments

Watch Now!
Maxgraft bonering: immediate implant placement

This video shows a live surgery using the maxgraft bonering, which is a pre-fabricated[...]

1 Comment

Watch Now!