Procedures May Be Needed Prior To Dental Implant Placement

added on: May 23, 2023

I recently had a consultation with a gentleman I’d seen a couple of years back. In our initial consult, we discussed his potential need for a bone rebuilding procedure prior to placement of dental implants. The added procedure, and additional cost, deterred him from moving forward.

Although we offer excellent payment plans, I understood his deflation with this added process. Fortunately, he returned several months ago and we updated his treatment plan and began the procedure. In about a month, he’ll have restored bone mass and enjoy biting, chewing, and laughing without worry.

Sometimes, these added procedures can be disheartening. I get it. After all, when a new patient comes for an in-office whitening only to learn they have periodontal disease that must be treated first, the excitement of achieving the end result takes a dip.

From a dentist’s perspective, however, proceeding with treatment without ensuring the patient’s results will have an optimal outcome is a disservice to the patient. In dental implants, several procedures are occasionally needed prior to implant placement. These may include:


This procedure is needed when an individual has lost too much bone mass to sufficiently support the implanted portion of dental implants. Bone loss is typically due to the absence of natural tooth roots in the jaw bone.

The upper jaw bone (maxilla) and the lower jaw bone (mandible) thrive on the presence of the tooth roots they hold. When teeth are removed, the bones no longer receive the nourishment and stimulation the tooth roots were intended to provide. This causes a shrinking of bone mass known as “resorption.”

Bone loss begins slowly the first year after tooth removal, yet accelerates with each passing year. For individuals who wear a denture, the pressure of wearing it speeds up the pace of bone loss. For those who sleep in their dentures, the 24/7 pressure on the bone ramps up the pace even more.

Dental implants halt the progress of bone loss. However, for a successful outcome, they must be implanted into bone mass that adequately supports them. In the past, lack of bone depth could necessitate the need for a bone graft, often taken from a small portion in the hip. Today, there are less complex options, including the application of a bone rebuilding material.

The procedure for rebuilding bone is minor and performed in our Shelby Township dental office. While the patient relaxes comfortably under Oral or IV sedation, a medical grade material of bone minerals is deposited into the bone through a small hole. This material stimulates the body’s natural ability to generate new bone cells. Once the bone mass is to a sufficient level (usually within several months), dental implants can be placed.


This procedure is needed when there is insufficient upper jaw bone mass. Dental implant placement in this area when bone mass is shallow creates a risk for the implant(s) to penetrate the sinus cavity. Should this occur, removal of the implant is necessary. While this results in loss of the implant, it adds to treatment time and a repeat of the expenses associated with implant treatment.

The sinus lift procedure involves adding bone-building material through a small hole in the sinus area. Once the material is placed, the hole is closed over with gum tissues for healing. Over the next few months, the applied material strengthens and restores bone mass. Dental implants can typically be placed within 4-6 months of a sinus lift. In some cases, however, implants can be placed at the same time the sinus lift is performed.

A sinus lift is performed as an in-office procedure as the patient relaxes in a “twilight sleep” state. Most sinus lifts are completed in one to two hours. After the procedure, there may be some discomfort and facial swelling with some bruising. Most people do fine with over-the-counter pain medications to resolve any discomfort. Antibiotics and mouthwash are generally prescribed to reduce the risk of infection.


Healthy gums are a must for dental implant placement (as is the case for any cosmetic or restorative procedure). If implants are placed in gum tissues that have any level of periodontal disease, the inflammatory bacteria of the disease can work down into the bone supporting the implant. This can lead to the need for removal of the implant(s) in order to adequately treat the disease.

The treatment for gum disease depends on the level it is at: Gingivitis or Periodontitis. Typically, restoring the gums to a healthy state requires a non-surgical procedure known as Scaling & Root Planing. This is done in our dental office by our registered dental hygienists.

Scaling & Root Planing is a deeper dental cleaning that reaches beneath your gum line to remove plaque and tartar on tooth root surfaces. In addition to thoroughly cleaning your teeth, the hygienist smooths away any rough spots on tooth roots. This helps prevent bacteria and plaque from reattaching. This may be followed with an antibiotic medication placed in the treated space between the gums and teeth.

In some cases, a dental laser may be used to resolve periodontal disease. In this, we use a small laser to remove diseased tissue and kill bacteria under the gums. An appealing advantage of laser therapy is it generally eliminates the need for incisions or sutures.

New technology is continually leading to miraculous developments in many medical or dental procedures. Many of these are able to minimize the complexity of treatment, enhance comfort and speed healing time. And, many can simplify the process so it is less complex than what people may anticipate. (Get to know our advanced technology at: DrBarbatTechnology

And, our dental implant patients feel their “new smiles” are well worth any added steps. Dental implants have an exceptional track record with a success rate that is very high – up to 98 percent by some estimates. When a sinus lift is performed in conjunction or prior to implant placement, for example, studies have shown success rates up to 100 percent. (Dr. Barbat shares more about Dental Implants: DrBarbatDentalImplants)

Our goal is to help patients enjoy an optimal outcome, a comfortable process, and a smile that lasts a lifetime! To discuss your specific needs, schedule a private consultation in our Shelby Twp dental office. Call 586-739-2155 or tap here to arrange a free consult.

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Dr. Ban R. Barbat

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