Dental Implants with Bone Loss

Bone loss is the most common reason patients are told they "can't have implants." It is almost always fixable. Dr. Qiu trained at UCLA in advanced bone grafting techniques and has restored over 200 patients who were turned away by other offices.

Modern grafting, sinus lifts, ridge expansion, and in extreme cases zygomatic implants make placement possible for over 95% of patients with significant bone loss. The trade-off is timeline — adding 3–6 months to the treatment plan — and additional surgical fees.

The moment a tooth root leaves the jaw, the bone underneath begins to resorb. CT studies show you lose around 25% of bone width in the first 12 months after extraction and another 5–10% over the next four years. Five years without a replacement and the bone at that site is often too thin or too short for a standard implant.

Long-term denture wear accelerates this — denture pressure transfers force to the bone but in the wrong pattern, and the bone shrinks faster than it would in a healed socket. Patients in dentures for 10+ years often have severe ridge atrophy.

Periodontal disease (advanced gum disease) actively destroys bone around still-present teeth. Patients who lose teeth to gum disease arrive with both missing teeth and missing bone in the surrounding ridge.

For most bone-deficient sites, we use particulate bone graft material — ground bone, either from a tissue bank or synthetic — packed into the deficient area and covered with a resorbable membrane. The graft acts as a scaffold for your own bone to regrow into.

Healing takes 4–6 months. During that window, your body remodels the graft into living bone. Once we confirm adequate bone volume on a follow-up CT, we place the implant.

Particulate grafting adds $1,500–$3,000 per site depending on graft volume. About 70% of our bone-loss patients are restored with particulate grafts alone.

The upper back jaw is where bone loss is most extreme. The maxillary sinus sits directly above the back teeth, and once those teeth are gone, the sinus floor can drop down to within 2–3 mm of the gum — too shallow for an implant.

The fix is a sinus lift: we lift the sinus membrane upward and pack bone graft material into the space underneath. After 4–6 months of healing, there is enough bone height for a standard implant.

Sinus lifts add $2,000–$3,500 per side. They sound dramatic but are routine — Dr. Qiu performs them weekly. Recovery is similar to implant placement: 48 hours of mild discomfort, back to work at 48 hours, full activity at one week.

When the ridge is too thin (less than 4 mm wide) for an implant, we have two options. A block graft takes a thin slice of bone from another part of your jaw (usually the back of the lower jaw) and screws it onto the deficient site. Six months of healing later, the ridge is wide enough for placement.

Ridge expansion uses specialized chisels to gently split a thin ridge in half, creating a channel that accommodates the implant immediately. We pack graft material around it. Healing is similar to standard implant placement.

Choice between the two depends on ridge width, bone density, and how much volume needs to be added. We decide at the planning stage from your CT scan.

A small percentage of patients — usually long-term denture wearers with severe upper-jaw bone loss — have so little bone that even grafting and sinus lifts cannot rebuild a viable foundation. For these cases, zygomatic implants anchor into the cheekbone (zygoma) rather than the upper jaw.

Zygomatic implants are 30–50 mm long (compared to 8–14 mm for standard) and require specialized training and CT planning. They allow patients with no bone to receive a fixed bridge on the day of surgery — no grafting required.

We perform zygomatic placement for the small subset of patients who need it. The consult will tell you if you are in that category.

If you have been told no by another practice, bring whatever they gave you: panoramic X-rays, CBCT scans, written treatment plans, any letters from referring offices. The more we know going in, the more useful the $145 consult will be.

The consult includes a new CBCT scan and 45 minutes with Dr. Qiu. You leave with a clear yes or no on whether implants are possible for your specific bone situation — and if yes, a written treatment plan with exact pricing.