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Installing Implant into Graft: Will I Get Stability Even If Don’t Engage any Original Bone?

Last Updated: Dec 05, 2011

Dr. S asks:
How long would you wait to place the implant in this grafted site?

I took this tooth out 6 months ago and it was quite infected with the buccal plate blown out. Patient is healthy 66 y.o. I grafted with MinerOss and covered with a Cytoplast PTFE membrane. The site has healed well and has excellent buccal/lingual dimensions. No, I will not be taking a CBCT in this case, but I will measure the thickness with calipers up and down to determine if I need to choose a smaller implant than the 5mm I am planning on.

The reason I am posting this is because it looks like my entire implant will be in graft. Normally I have chosen to place implants into areas that can gain all the initial stability from the original bone and not rely on the grafted portion. So my grafts are normally just fillers. I know you will all likely say that waiting 6 months was above and beyond the requirement, but what should the standard be to guarantee excellent stability and a fully vascularized site? And does the wait time increase in a larger graft site?

pre-op showing infection

six months post-op. Note that the depth of the graft is at least 17mm from the crest, so there is really no way I will engage any original patient bone.

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