Implant Surgery: Bone Graft is Exposed

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.

We had taken on a referral case, which had 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 had fitted the patient with a temporary bridge that inadvertently put some 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 in the clear retaining part of the Essix bridge on the palate. Regardless, it had dug itself 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 temporary 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 over bulked and overbuilt the bone so there is extra to work with rather than not enough.

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 on its own, however, in this case, this did not work even though the socket started off very small.

At first, the hole was not really present, but it kept growing 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.

In this case, we’ve gone the extra mile with block bone grafts and GBR membrane techniques.

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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,m 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.

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How we can help

The Gentle Dental’s dentists like Dr Ali Rifai, often receive messages from people around the UK with bone exposed 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 area of 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

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!)

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