Implant Surgery Case Study

Here at the Gentle Dental, with our work, we do not have complications too often, but we have come across one recently, which is worth sharing.

Bone Graft is Exposed

We had taken on a referral case with a very large block bone graft in the front of the mouth for implants.

The block bone graft was secured by screws, which we removed later. This provided an excellent opportunity to yield plenty of bone for the front two implants.

Dr Rifai fitted the patient with a temporary bridge that inadvertently put pressure on the gums after surgery. You do not want to put any pressure on the gums following surgery. In this case, this happened due to a tear on the palate’s clear retaining part of the Essix bridge. Regardless, it had dug into the gum, thus exposing newly healed bone.

This meant that the bone was showing.

dental implant before and after

How we rectified the problem

Here, we had to really adjust the Essix temporarily to clear out all the bone that was needed.

Please note that this is an open patient case where the full procedure has not been completed.

We have extracted one tooth so that the gap is now two-tooth big.

Then, we purposely overbulked and overbuilt the bone, so there is extra to work with rather than insufficient.

The right thing to do in this situation

Dentists should proceed with caution here as the correct thing to do is not to try and reclose the open wound with stitches – this can make things worse.

It’s not common knowledge that a noncritical, more basic bone socket graft may fill in independently. However, this did not work in this case even though the socket started very small.

At first, the hole was not present, but it grew larger before it shrank down to where the pink gum covered the bone again.

One thing to note about the Gentle Dental is that we are always here for our patients and will do whatever it takes to correct and solve dental issues.

We’ve gone the extra mile with block bone grafts and GBR membrane techniques in this case.

our dentists at work

Quick contact

welcome to our practice in surrey

Bone closure technique

We removed a slight bit of the surface bone and drew blood from the patient’s right arm.

With their own blood, special cells in the bloodstream (platelets) were concentrated to make a gel membrane called L PRF.

Then, we placed the L PRF on the open wound and stitched a web to hold it in place.

Over the course of about two weeks, we saw the patient twice more to repeat this process to add more L PRF under the special webbing.

And just like that, the bone graft exposure closed – complication solved, and crisis averted.

How we can help

The Gentle Dental’s dentists, like Dr Ali Rifai, often receive messages from people around the UK with bone exposure or similar complications, where they might have lost their entire bone graft and need to start again.

Our methods usually involve very efficient and natural ways to close wounds and use our expertise to provide solutions to prior bone grafts that were completed with poor technique.

Your comments and questions are welcome.

Call 020 8224 7562.

Dr Ali Rifai

BDS (London) PgCert MClinDent (Implantology)


GDC No. 154456

Dawn SwansonDawn Swanson
10:27 24 Nov 22
I have been with the Gentle Dental Practice for 8 years, the care and service I have received has always been 5 star. I have recently used their new hygienist Nicky who is great. Looking for a new dentist just contact their very friendly and proffessional team.
George HorseyGeorge Horsey
18:54 15 Nov 22
Dental Impant Surgery:I had my dental implants fitted recently and I am extremely happy with the outcome. Ali and the team have done an amazing job since I lost my 2 front teeth over 6 years ago. I had to wait for the surgery for a long time due to my age and the issues surrounding having implants at a young age.I finally had the surgery 12 weeks ago and had my two new crowns fitted last week. They look absolutely amazing and the whole procedure was way less painful than I ever thought it would be.I would highly recommend getting your implants done at the Gentle Dental Practice, you won't regret it!A massive thank you to everyone at the practice!
Deeban SkandalingamDeeban Skandalingam
12:06 03 Nov 22
Fantastic work on my teeth and I would highly recommend! My teeth turned out better than I had even hoped for. If you are in need of any dental work, you would be doing a great disservice if you didn't speak to this practice first. The staff were extremely friendly, there were text updates and all in all an excellent service from start to finish. If you haven't guessed already, I am thoroughly pleased with The Gentle Dentle. Thank you!
Pippa HarveyPippa Harvey
14:54 26 Oct 22
Like many people, I have an immense fear of dentistry, and dentists, due to previous experiences.I had two broken teeth and one that had been treated incorrectly by an NHS dentist. I had been in daily pain for about 18 months, and had been put on a 6 month waiting list by my NHS dentist.I called gentle dental to explain my problem and they offered me a same day appointment. They were kind, compassionate, understanding, patient and validating. I’m not sure anybody ever feels completely comfortable in the chair, but It’s the closest I’ve ever come!The work needed was carried out, all of the staff were kind and welcoming, and it showed me that the dentist doesn’t have to be a dreaded place!Thank you so, so much gentle dental! I will definitely be returning.
Tilesh PTilesh P
15:45 14 Sep 22
Dental Implants - 3 New Teeth - June 2022I had the most professional and pain free experience when getting my new tooth implants at Gentle Dental. Honestly I put it off for some many years because I just didn't want to go through the pain. But my experience was totally the opposite. Ali and the wonderful girls were there every step of the way. All my questions got answered and I was reassured everything would work out well. And it did. I was worried for no reason.I did think about going abroad to have it done but when you consider the risk factor, time and professional standards - it made no sense to me. I have known Ali for a long time and knew I would be in the best hands and if there were any issues these would could be resolved easily.If you are thinking of having dental implants at Gentle - don't waste any more time. Just book and get it done.Was it painful ? No, uncomfortable for a few days, yes for sure.I just wish I had it done sooner. Thanks guys, love my new teeth 🙂
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!)
Eva AugustEva August
07:11 06 Nov 21
I’m so happy to find this practice. I suffer from anxiety and high sensitivity to pain. It was very stressful for me going to dentist after years of fear. The team not only make me calm and welcome but I FELL ASLEEP during treatment with Dr Marshall ! So understanding and caring. Thank you!
Marc NevittMarc Nevitt
11:35 11 Oct 21
I have been using this dentist for well over a decade and can honestly say my teeth would be in a far worse situation if wasn’t for the Gentle Dental practice.My most recent visit was for a filling .. barely felt the injection!I would highly recommend this dentist to anyone, but especially if you’re teeth require a high level of care like mine.
Emma BrauerEmma Brauer
08:44 04 Aug 21
This place was recommended to me by family and for a nervous patient the best experience. The reception welcome is cheerful and friendly, beautifully modern area with hot drinks and water on offer.I needed implants, crowns and bridges followed by whitening, so lots of appointments. My dentist Mr Ali Rafai was superb from start to finish, so professional and personable. Throughout the whole process I was cared for wonderfully plus lots of laughs along the way. The constant care during appointments was very comforting, no rushing, and I knew I my needs were Mr Rafai's priority. Plus check up call the next day without fail to make sure everything was going well.Absolutely deserves five stars!
Alan SamuelAlan Samuel
13:30 14 Jul 21
Fantastic experience with Ali. It took 18 months including bone grafting, removing and replacing failed dental implants, invisaline for my bottom teeth which were all over the place and some veneers but now I'm delighted with the outcome.Ali was always very clear about how this wasn't an overnight solution in an honest and forthright manner which gave me confidence that he would deliver results.I was offered several overnight solutions from other dentists locally at a fraction of the cost but when I see how much effort and detail that went into my plan, I know i made the right choice.
Kurt JohnsonKurt Johnson
17:48 14 May 21
I have got no complaints about this Dental Practice. They were all very friendly and accommodating and always professional.My dental treatment was also really good, everything went according to plan and the results are great!I am VERY happy with the outcome and would recommend them anytime!

Get an interest-free loan in under 5 minutes

It only takes 2 minutes to apply and you’ll get an answer immediately – applying for a loan has never been easier.

0% finance is available for many treatments up to £30,000. Credit decisions will be subject to individual circumstances. You must be over 18 and earn an income to apply.

Available to Chat whatsappimage