How to Solve Insufficient Available Bone for Molar Implants in Gangseo-gu Dentistry with Navigation First and Second Surgery

Hello,

I am Won Yujin, director of Gangseo-gu Dentistry, Smile Surgeon, who restores your healthy smile.

Are you planning treatment after losing a molar,

but were told that the available bone is insufficient?

What is available bone?

It refers to the amount and quality of alveolar bone

that remains sufficient and appropriate

for fixture placement.

It is a term that broadly refers to the height and width of the bone,

as well as its strength and density.

For an implant to be placed successfully,

there must be enough bone of sufficient quantity and quality

left in the jawbone.

If the available bone is insufficient,

additional treatment to reinforce the bone,

such as bone grafting or sinus lifting, is needed.

Through CT imaging,

the height, thickness, and density of the jawbone

must be accurately evaluated.

In this process, the degree of available bone

acts as a factor that determines

the treatment plan and prognosis.

Gangseo-gu Dentistry explains

1. Main methods applied when available bone is insufficient

When placing a molar fixture,

if the available bone is insufficient, several methods

can be applied.

The first is bone grafting.

Autogenous bone, allogeneic bone, xenogeneic bone, or synthetic bone, etc.

are grafted into the implant placement area

to increase the amount of bone.

A representative technique is guided bone regeneration,

in which the graft material is placed and covered with a membrane

to guide bone regeneration.

The second is sinus lifting.

It is mainly used in upper molar implant surgery

when bone height is insufficient.

This method lifts the floor of the maxillary sinus

and fills the space with bone graft material

to expand the bone.

Gangseo-gu Dentistry explains

2. Simultaneous sinus lift and navigation guide use

When performing a sinus lift

and a navigation guide simultaneously,

several factors are considered.

Accurate 3D diagnosis and planning are important.

Before surgery, the anatomical structure of the maxillary sinus

is precisely analyzed using 3D CT and an intraoral scanner.

The thickness of the remaining bone, the position and thickness

of the sinus membrane, and the implant placement site

are carefully reviewed.

Using a navigation system,

the fixture placement and sinus lift location

can be simulated in advance.

Planning the optimal position and angle

improves accuracy.

The fabrication of the navigation guide and management of registration error

are also important factors.

CT and intraoral scan data are needed

to position the navigation guide device.

At this time, registration error in the guide

may accumulate, so error must be minimized

during all data registration processes.

In actual treatment,

proceed carefully while keeping the possibility of error in mind.

Gangseo-gu Dentistry explains

3. Key considerations in the first surgery

First, when lifting,

preventing damage to the maxillary sinus membrane is important.

Because the floor of this area

is made of a thin membrane, careful manipulation is needed during placement

to avoid damaging the membrane.

The navigation guide helps to a certain extent,

but in actual clinical practice,

one must always be prepared for the possibility

of membrane rupture or mucosal damage.

When placing the fixture,

initial stability must be secured

to reduce the risk of early failure.

When implant placement is performed simultaneously with sinus lifting,

thin bone may make initial stability difficult to achieve.

If necessary, sufficient bone graft volume should be secured,

or staged second placement should be considered.

Checking the placement environment and the patient's mouth opening

is also an important consideration.

Posterior access may be limited by the patient's mouth opening.

Because of the size of the navigation implant guide,

visibility and accessibility may be reduced,

so adequate visibility and access must be prepared in advance.

Gangseo-gu Dentistry explains

4. Second surgery and the treatment completion process

The second stage is

relatively simpler than the first.

After confirming whether the implant placed with sinus lifting

has properly integrated with the bone,

the abutment is connected.

Afterward, following a healing period of about 2–3 weeks,

the final crown is fabricated.

A molar crown should be made sturdy enough

to withstand chewing forces.

A natural-looking crown is made to match each person's tooth color and shape.

After treatment is completed,

regular checkups and management are necessary.

The area that received sinus lifting may require

more careful care than a standard implant.

In general, follow-up examinations every 6 months

are needed to check the condition of the fixture

and surrounding tissues.

Smile Surgeon,

rebuilding your healthy smile,

this was Director Won Yujin of Gangseo-gu Dentistry.

Thank you for reading this long post.

Treatment period: 2025.01.10~2025.07.10 ​