Complex Implant Cases: Making Impossible Dentistry, Possible

Has your local practice or dentist told you “no”?

Have you been made to believe that your missing teeth case is too complex?

Have you been told you do not have enough bone or gum and that nothing can be done?

We are often asked to give second opinions on cases such as All-on-Four, sinus lifts, multiple implants, bone augmentations and severe gum disease. Sometimes there can be so many dental problems with a patient you may not know where to begin.

Many dentists refer patients to The Gentle Dental because of our implant experience and skill level, not to mention the advanced technology and equipment we have at our practice. 

For us, we often find that nothing is impossible and that there is always something we can do to help you feel better about your smile.

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Defining complex cases

The following can threaten the success of an implant:

  • Tooth decay and damage
  • Active periodontitis or gum disease
  • Oral infections and sores
  • Horizontal or vertical bone loss and tooth mobility
  • No adjacent teeth, or those present in unsuitable positions
  • Lack of bone depth

As implant dentistry requires special attention and knowledge in periodontal disease, patients finding the right dentist to trust is extremely important to prevent implants from failing.

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How to simplify challenging implant cases

When your case is not properly assessed or a dentist does not follow proper protocol, the chances of your implant failing increase.

They occur due to:

  • Poor dental treatment
  • Misdiagnosis
  • Allowing problems to persist untreated
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Lack of jawbone density

Dental implant cases often describe a lack of bone present in the jaw, which prevents the safe and stable placement of implants. Within just six months of losing a tooth, the bone in the jaw can deteriorate – it will never grow back.

Typically when there is not enough bone mass to support the dental implant a bone graft will be required.

The placement of implants during advanced bone augmentations will demand a higher level of surgical expertise and the significant capacity to care for such patients.

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How we handle complex implant cases

An intricate case is not just defined by the difficulty of a procedure, but rather the potential issues that can compromise the function, comfort and even longevity of the final tooth or teeth.

The prosthodontic team dedicated to your procedure are qualified in managing the occlusal scheme, which includes modifications to the vertical dimension and position of your teeth and how these developments interact with existing dentition (if present) and their relationship to the jaw.

The result of a case cannot be easily visualised without extensive diagnostic and treatment planning techniques.

Our implant consultations aim to identify any and all the potential issues provided in our diagnosis.

Assessing this in the first stage helps us to build trust with our patients rather than highlighting or discovering these issues as we continue with treatment.

expert implant dentist team

Complexity factors include:

  • Multiple missing teeth and the variety of options: which one is best, not only for the patient but for the expected outcomes, how they will be received and budget
  • Large posts and cores – do we keep them or extract them?
  • Do we try and save certain teeth or consider a full mouth reconstruction?
  • Potential medical problems that could compromise treatment
  • When more than one specialist is involved
  • Managing gum disease and root decay

Each factor adds additional complexity to the case, with the number of problems increasing significantly. The Gentle Dental, and Dr Ali Rifai in particular, continuously have heavy involvement in treating complex cases, and in the past, has been able to provide long-term success and overall peace of mind.


One step at a time

We take things at your pace and break our treatment up into stages, which will be agreed upon with you upon drawing up the treatment plan.

This allows our clinicians to properly assess your condition and your ability to cope with these procedures.

If you’re unsure about anything, or would really like a second opinion on your condition, give the doctor a call on 020 8224 7562.

Edward CrameEdward Crame
13:43 04 Dec 21
Very happy with all aspects of the work they have done. Very clean, professional and well run business.
Lynn HuddartLynn Huddart
12:43 24 Nov 21
Dr Ali Rifai was professional and I am very pleased with the outcome of my Invisalign's. I have been with this practice for many years and would highly recommend. The staff are very friendly and nothing is an issue.
Jonathan PlumbJonathan Plumb
11:52 24 Nov 21
Can't thank this practice enough for all their help. I don't post reviews very often, so when I do, it's because an impression has been left! Dr Ali saw me at short notice to help fix a broken tooth. The nurse (I think her name was Danni) was so helpful and kind, as were the rest of the team. Thank you for being there for me in my hour of need (the same day i asked for an appointment!)

Our skills and experience set us apart

Why choose Dr Ali Rifai to treat your complex case?

  • 25 years of skill and experience in implantology, prosthodontics and periodontal work; there is nothing Dr Ali has not dealt with
  • Delivers an understanding approach, which allows him to work with patients to find alternative and effective treatments that suit them
  • Has access to the latest dental improvements, technology and software that provide better, more achievable results that go beyond just promises
  • 98.2% success rate for implant placements
  • Easily can provide long-lasting stable solutions to repair your smile

Single Implants

Often used in simple cases where one tooth has been lost by accident or trauma. More.

Multiple Implants

Used in cases of multiple tooth loss in different locations in the mouth, where teeth are not missing in a row. More.


Perfect for full mouth reconstructions, where patients have experienced tooth loss on the upper and lower jaws. More.


When securing implants to the jawbone is not possible, zygomatic implants are used to attach to the bone in the cheekbone. More.
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