Bone Loss around a dental implant

Bone loss is common, and it can happen for a lot of reasons. For example, you may have missing teeth or severe periodontitis, both of which can lead to dental bone loss. One report suggests that 14.9% of the total population with periodontal disease has moderate bone loss.

If you’re considering getting dental implants, bone loss is something that we’ll examine in our office to determine if you’re a good candidate for the procedure.

X-ray of normal bone and bone loss

How Does Bone Loss Affect Dental Implants?

Dental implants are different from bridges or dentures, making them more realistic and secure. However, the procedure will require posts to be placed in your jawbone to act as an anchor for your new teeth.

A lack of bone can increase the risk of implant failure or make implants impractical for you.

Missing teeth can cause bone loss. When you have missing teeth, the jawbone is still strong at first. However, over time, you start to lose bone. Why? Teeth do a few things:

  • Provide constant pressure on the bone
  • Create force on the part of the bone where the tooth is present

Pressure and force on the bone keep it strong and healthy. Once this force and pressure are gone, the bone will begin to weaken. If the tooth loss was due to impact, there’s also a chance that some of the jawbone was lost in the accident.

All of these factors must be considered before going forward with dental implants.

If we find that you do have severe jawbone loss, there are two main options that we may consider:

  1. Bone grafting
  1. Zygomatic implants

Let's take a look at both of these options to see which may be best for your case.

Can You Still Have Dental Implants When You Have Severe Bone Loss?

Severe bone loss will require us to reconsider your implants or may require some additional steps to be taken to restore the bone.

Bone Grafts  

Annually, 2.2 million people have a bone graft of some kind. The procedure can help you restore the lost bone that often causes your cheeks to sink inward.

How Bone Grafting Works

Puros bone graft material
Zimmer Biomet Puros Cancellous Bone Graft

Implant posts need enough bone to exist to be strong enough to hold the post in place. If you have a bone graft placed, it will help do two main things:

  • Add bone mass
  • Regenerate bone (sometimes)

The process will require us to lift the gums, place either synthetic or your own bone in the area, and then wait. Of course, we’ll use anesthesia, and the process is a little more complex. However, this is the basis for a bone graft.

Once we place the new bone, the existing bone and new bone will need to fuse in a process that can take four months to complete.

When the graft is fully healed and we’re confident that the jawbone is now strong enough for an implant, we can proceed with a traditional implant. There's also the option of a Zygomatic implant, which we will cover shortly.

Advantages of Bone Grafts

  • Helps strengthen the jaw so that it’s strong enough to hold the implant post
  • May help promote bone regeneration naturally, allowing you to have a stronger jawbone overall
  • Prevent further bone loss when an implant restores the pressure on the bone
  • Improve basic facial structure

Disadvantages of Bone Grafts

  • Healing will take months
  • Risk of failure

While rare, bone graft failures are certainly possible. Failure is often due to infection, and this can lead to gum infection, fever, sensitivity and pain. We'll take every precaution possible to reduce the risk that your bone graft will fail. However, there is always a very small risk of failure.

Who’s a Good Candidate for Bone Grafts?

We will take the time to ensure that you’re a good candidate for bone grafting before we begin the procedure. The last thing we want for our patients is to experience failure after their graft. You are a good candidate if you have missing teeth and have experienced jawbone loss.

However, there may be underlying conditions for the bone loss that make a graft impractical.

For example, there are some rare cases when a person has a disease that may impact bone strength and make them not a good candidate for a bone graft. We'll discuss your candidacy in our office to ensure that a bone graft is your best choice to restore your smile with dental implants.

In cases where bone grafting isn’t practical or something the patient wants to pursue; we can consider a different type of implant: Zygomatic implants.

Zygomatic Implants

Zygomatic implants are an alternative to bone grafts for those who want implants and have severe bone loss. In fact, these implants are quickly becoming the standard for those who suffer from severe bone loss and cannot use traditional dental implants.

Although they are still considered a new development, zygomatic implants have been around since the late 1980s

Zygomatic Implants
2 regular implants up front at 2 large Zygomatic implants in the rear

How Zygomatic Implants Work

Zygomatic implants have a longer implant design, and they are angled for anchoring into the upper jaw and cheekbone.

Regular implants are implanted into either the upper jaw (maxilla) or the lower jaw (mandible). Zygomatic implants, on the other hand, are implanted into the zygomatic bone, or cheekbone. Your cheekbone does not suffer bone loss the same way as the jaw bones.

Advantages of Zygomatic Implants

There are many advantages of zygomatic implants, including:

  • No grafting is required. With zygomatic implants, there’s no need to go through the lengthy and sometimes painful process of bone grafting.  
  • Same-day placement. Because zygomatic implants already provide a secure foundation, there’s no need to wait for a dental prosthetic. You can walk out of the office with your newly restored tooth.
  • High success rate. Just like traditional implants, zygomatic implants have a high success rate.
  • Quicker healing. Generally speaking, zygomatic implants have a quicker healing time than bone grafting.  

Disadvantages of Zygomatic Implants

Zygomatic implants also have some drawbacks, including:

  • Higher risk of sinusitis. Some patients develop sinusitis, and treatment can be challenging. In severe cases, implant loss may be possible.

With zygomatic implants, there is also a small risk that the implant will fail or an infection may develop.

Who’s a Good Candidate for Zygomatic Implants?

An ideal candidate for zygomatic implants is someone who needs to replace a missing tooth but has suffered severe bone loss and can no longer support a traditional implant.  

If you need to replace a tooth and have suffered severe bone loss, we can discuss whether a bone graft or a zygomatic implant may be the best option for you.

Are Implants the Best Option for Tooth Replacement?

Dental implants are often touted as the best option for tooth replacement, and there is good reason for that. Implants are a permanent solution for tooth restoration, and they can help restore the natural look of your smile.

The Pros of Implants

There are many advantages of implants, including:

  • Long-lasting. With proper care, implants can last decades. With a 98% success rate, implants have been shown to be one of the most effective treatments for tooth restoration.
  • Natural looking. Because implants replace the individual tooth and do not rely on neighboring teeth, they are the most natural looking. Implants are designed to mimic the natural size and shape of the tooth it’s replacing.
  • Cost-effective. Implants may have a high upfront cost, but they are long-lasting with proper care. Other less expensive restoration options must be replaced every several years.

Another great advantage of implants is that you can replace as many or as few teeth as you want.

The Cons of Implants

Of course, there are also some drawbacks of implants that should be considered, including:

  • Crowns may need replacing. Although the implant itself can last for decades, the crown that sits on top of it may need to be replaced every several years.
  • High upfront cost. Implants are one of the most expensive options for tooth restoration.
  • Lengthy process. The entire process of putting in an implant can take several months.

Another obvious con of implants is that they’re not easy to use when there is severe bone loss.  

3 implants side by side - one with severe bone loss

Dental Implant Alternatives

If implants are not an option for you, there are a few alternatives that you can consider, including:


Bridges help fill the gap caused by your missing tooth. With this restoration option, two crowns are placed on each side of the space where your missing tooth once sat.

While not as long-lasting as an implant, bridges are a viable alternative for replacing a lost tooth. Proper care and avoiding hard foods can help keep maximize the lifespan of your bridges.


If you are missing several teeth, dentures may be an option if implants are not. Full or partial dentures fit over your gums and are designed to look just like your natural teeth. They are custom-fitted for your mouth and are often indistinguishable from natural teeth.

If have tooth loss, whether due to extraction, injury or illness, it’s important to replace it as soon as possible. Failure to replace a lost tooth can lead to shifting and other issues that can affect your oral health. We can discuss your options for replacement, including whether an implant will be the right decision for you.

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Dr. Gurpreet Sidhu - Dentist at Lighthouse Dental Centre and Blue Water Dental
Dr. Gurpreet Sidhu

With nearly two decades of experience, Dr. Sidhu enjoys helping his patients learn about dentistry. Knowledge is meant to be improved, challenged and shared.

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