Some patients are ineligible for dental implants due to inadequate bone mass. After a tooth is lost, the jaw immediately beneath it undergoes a process called resorption. Since it no longer supports the tooth, this section of bone loses some of its mass. This mass has to be restored before the bone can support implants, and this is usually achieved with bone grafting—manually adding bone tissue (donor, synthetic, or your own) to the site. The trouble is that some patients are ineligible for bone grafting.

Your Health

It might be that you have a medical condition which means that bone grafting is unlikely to be successful. This could be an inherited metabolic disorder or a condition that directly affects your bones, such as osteoarthritis. If your health prevents you from receiving bone grafting, does this mean you need to start considering non-surgical tooth replacement options?

Non-Surgical Options

While there are numerous non-surgical methods for replacing missing teeth (such as dental bridges, or dentures), these options won't be as robust as a dental implant. Since it replicates the tooth's root structure, a dental implant will then recreate the form and function of a natural tooth, both above and below your gums. Even when you can't safely undergo bone grafting, it doesn't mean you can't receive an implant.

Transosteal Implants

Ask your dentist about transosteal implants. These implants are not widely-used but can offer a stable base for an implant when a patient's bone cannot be directly treated. The device involves having a small metal plate placed on the underside of your mandible (lower jaw). This creates a stable base for the implant, and it's only the mandibular that can receive a transosteal implant. The plate features several small rods projecting upwards, to secure it to the bone. Your dentist then makes a small access hole in your jaw, through to the plate. This access hole will be filled with your implant, which will then be held in place by the metal plate. Finally, the prosthetic tooth is attached to the implant.

After Implantation

Standard implants require a healing process called osseointegration, in which the bone fuses to the implant to secure it. This stabilization is immediate with a transosteal implant, although the minor surgical procedure to fit the implant will require a recuperation period. The soft tissues in your mouth will need to adequately heal as well. 

When you're not able to receive bone grafting, it's not necessarily a dealbreaker. Transosteal implants could be the ideal solution to your particular problem.