In many cases, an implant can be placed at the time of tooth extraction. Since the diameter of the implant is slightly smaller than the extracted tooth socket, bone graft is necessary to fill the gaps between implant and extracted socket wall.   The advantages of immediate implant placement are 1) shortening the waiting time, 2) minimize surgical procedure, and 3) faster healing process.

When front teeth need to be replaced and cosmetics are of concern, Dr. Wang will extract the tooth and place an implant without cutting the gum.  He will also fabricate a temporary crown and attach it directly to the implant so that no temporary removable appliance is required.  When implant is healed, the temporary crown will be removed and replaces with a permanent crown.

Following diagrams are illustration of the Immediate Implant Placement with Implant Support Temporary Crown.

After tooth is extracted, the surrounding bone begins to shrink.  Excessive bone shrinkage may result into a thin bony ridge, which cannot accommodate implant.  Placing bone graft into the extraction socket prevents excessive bone shrinkage and preserves bone thickness.  Implants can be inserted after a healing period of 3 to 4 months.

The following diagrams are illustration of Site Preservation Procedure

Every person has two maxillary sinuses (right and left) that are located above the upper molars and premolars.  After the removal of tooth, the sinus cavity will gradually expand into the surrounding bone.  The available bone height (distance between gum and floor of sinus) is reduced as sinus expands. The minimum desire implant length at the molar and premolar area is 8mm.  Sinus Lift procedure is indicated when the available bone height is less than 8mm.

Sinus Lift is a surgery procedure that places bone graft into the sinus cavity.  This procedure can be accomplished with two different approaches:  “Lateral Window” and “Osteotome” technique. In general rule, “Osteotome” technique is recommended if the implant site has at least 5 mm of available bone height. “Lateral Window” technique is more suitable when the implant site has less than 5mm of existing bone height or multiple implants are scheduled.  Only doctor can determine the appropriate technique for a given situation.  In some instances, implants can be placed simultaneously with sinus lift procedure.

The following diagrams are illustration of the Sinus Lift Procedure with “Lateral Window” technique and “Osteotome” technique

Particulate bone (small bone particles) and tenting device are the most common materials utilized for this procedure. The tenting device creates the desired ridge shape (bone thickness and/or height) that will be sufficient for future implant placement. The bone particles are placed between the space created by the tenting device and existing bone structure.  Then, gum is stretched to cover the tenting device and bone particles completely. During the healing period, the tenting device prevents the gum growing into the bone graft area and maintains the desired ridge shape.  Approximately 6 months of healing period is required for your body to convert the bone particles into your own bone.  At the time of implant placement, the tenting device is removed and exposes the newly regenerate bone.  The rebuilt bone ridge has proper thickness and height to accommodate implant.

Following diagrams are illustration of the Ridge Augmentation Procedure