Not enough bone for dental implants? Options to discuss

Atrophy means a loss of tissue volume. Bone atrophy means less bone volume is present. The research collected for this guide identifies substantial atrophy as one situation in which corticobasal implants may be discussed.

Corticobasal describes implants that seek support in hard areas called cortical bone. That helps explain why one proposal may differ from a plan relying on another area for support. It does not make anatomy unimportant or mean the procedure fits every mouth.

Bring existing images and estimates to the consultation. Ask the second dentist to explain how the new proposal differs from the first. Different plans may start with different treatment goals. This guide cannot decide which plan fits your situation.

A bone graft is a procedure that adds material to increase the available bone. It may be part of an implant plan. Whether it is needed depends on the specific proposal. If one clinic includes a graft and another leaves it out, ask for a clinical explanation.

What is the graft intended to achieve? Which alternative has the dentist considered? Ask about the stages, too. Timing, cost and risks need an explanation during evaluation. Another patient’s schedule does not establish yours.

Avoiding bone grafts is a goal of this technique. Your doctor confirms whether it applies to your case at the evaluation with your test results. That does not eliminate every additional procedure or surgical risk. The review by Habash and colleagues considers it a possible option for severe atrophy while describing the evidence as limited.

Corticobasal anchorage is one option described in the research. It uses one-piece implants and seeks support in cortical bone. A prosthesis, the structure of artificial teeth, joins the implants. The plan depends on anatomy and the professional’s assessment.

Zygomatic implants are long implants that seek support in the cheekbone for certain upper-jaw situations. Pterygoid implants seek support in a region toward the back of the upper jaw. These terms describe different approaches. They are not interchangeable or suitable for every location.

The reviews by Brennand Roper on zygomatic implants and by Raouf and Chrcanovic on pterygoid implants provide longer follow-up than the research found for corticobasal implants. That does not let a reader choose from a list. A specialist must explain which options are feasible and the challenges each would present in the anatomy being assessed.

A conventional plan using tilted implants can also avoid a graft in some cases. The discussion therefore need not stop at grafting versus corticobasal implants. Ask which options the dentist has ruled out and why.

The International Implant Foundation document explains cortical anchorage and use of its system. The foundation is associated with that technique. Its document helps explain the approach but is different from an independent review of its advantages over other treatments.

Habash and colleagues reviewed literature made up largely of case reports. Joshi and colleagues also identified limits in the evidence. These publications do not support presenting corticobasal treatment as superior to conventional implants.

The collected research describes difficulties removing and replacing a basal implant if it fails. The dentist needs to explain that possibility before surgery. The repair or treatment-change plan at clinics associated with Hexa Smile is to be confirmed.

A percentage borrowed from another practice will not answer every question. Ask for results from patients treated by the professional who would operate. The clinics’ full-mouth case counts and years of follow-up are to be confirmed. First-day photographs cannot answer what happened over time.

Ask the dentist to show where the implants would go on your images. Request an explanation of nearby structures and the plan’s limits. You do not need to learn to read a CT scan to ask for a clear description.

If the proposal removes teeth still present, ask for the reason for each extraction. Extraction means removing a tooth. That decision requires a clinical examination. This page cannot determine whether keeping or removing a tooth is appropriate.

Bring your medication list and medical history for review. Low bone is one part of an evaluation. Eligibility depends on more than a scan or a technique’s ability to avoid grafts. These clinics’ specific eligibility criteria are to be confirmed.

You can also bring the earlier written plan. It gives the second dentist a concrete proposal to discuss. Ask whether the different recommendation reflects anatomy, the treatment goal or the type of support being considered.

US patients should discuss follow-up before buying flights. The CDC recommends arranging who will treat possible complications after you return home. A nearby dentist who knows the system cannot be assumed to be available.

Patients traveling from another Dominican province also need to ask how many in-person visits the plan requires. The checkup schedule is to be confirmed. Work out transportation once the clinical team sets that schedule. A fast first delivery can still require later visits.

Hexa Smile coordinates care. The clinics perform the procedures. Price, warranty terms and the required stay are to be confirmed. The company does not decide whether an image supports surgery. That decision belongs to the dentist after reviewing the clinical information. This guide prepares questions and provides no medical advice.

• Where is there too little support for the treatment you propose?
• What does the CT scan show, and what still needs an in-person exam?
• Which options involve grafting, and how will you use my test results at the evaluation to assess whether the technique designed to avoid grafts suits me?
• Why have you ruled out other options for this plan?
• What would happen if an implant failed, and what would that cost?
• What results can you show from your own patients over years of follow-up?
• Which visits must take place at the clinic, and who could treat me at home?