1. The patient has only one tooth. As you can see, all the other teeth have whole and healthy roots, well anchored in the mandibular bone.

2. Immediately after the tooth falls out, the bone begins to resorb in that area due to the lack of stimulus.What kept it before it fell was its root.

3. The more time passes, the more the mandibular bone is resorbed. If many years have passed, the implant can no longer be inserted directly because now the bone level is low.

4. If we placed the dental implant directly in the bone, it would be below the line of the other teeth which would make chewing difficult. In addition, it would not look too good aesthetically.

5. If we placed the implant at the level of the other teeth, the metal root would be extremely visible. Not only is it unsightly, but also unstable, because the implant is screwed too little.

6. Suppose we give up the implant and use a bridge or dental crown. This case is not optimal either because they will not have a fixing base and there will be a gap between them and the bone.

7. The only solution for lifting and reconstructing resorbed bone is bone addition. With the help of an instrument, the doctor fills the gap with a dental bone substitute.

8. After the substitute (dental bone graft) completely fills the gap, the implant surgeon isolates the addition work with the help of another dental instrument.

9. The end of the bone addition operation consists in sewing the area with sutures. The patient is sent home and the healing process begins. After a while the bone graft will be absorbed and fully integrated in the jaw.

10. After the absorption is over and the area is healed, the dental implant can be inserted. It will look and behave like a natural tooth, because the bone that supports it has been rebuilt.

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• Autologous graft (Autograft) - bone taken from your own body. It is usually obtained from below the knee, hip or even from the jaw by making a small incision and collecting a few milligrams of bone tissue.
• Alogrefa – banca de organe. Prezinta o rata de integrare si adaptare mai scazuta decat grefa autologa, lucru ce automat implica si costuri mai mari.
• Artificial graft (Alloplasty) - synthetic bone powder, manufactured in the laboratory. These artificial materials are processed and tested in the laboratories of internationally certified manufacturers.
• Grefa de origine animala (Xenogrefa) – obtinuta prin deproteinizare si prelucrare a osului de origine animala (bovina; cabalina; porcină etc…).

1. The operation begins with a usual anesthesia, as in the case of any dental treatment and continues with the extraction of the affected tooth (if applicable).
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2. The next step is to access the target site by separating the tooth gum and disinfecting the alveolar cavity (the area where the initial tooth was). After the root is cleaned and disinfected, it is augmented with a bone graft.

​3. La sfarsit se acopera constructia din os cu o membrana din colagen sau alt material si se sutureaza.

Sometimes, when the patient's clinical situation is not aggravated, bone addition can be performed under anesthesia during the insertion of the dental implant.

Sometimes, the waiting time or duration between the addition of bone and the dental implant is quite long (at least 3 months) and this is because, as I said, the bone substitute must osseointegrate (to connect with the natural bone).

However, it should not be exaggerated in terms of duration. Thus, if it is too short, osseointegration will not be done properly. Conversely, if we are too late, the newly created bone will resorb.

One of these cases is the lack of molar and premolar teeth (masses) located on the upper arch. When these teeth fall out, the sinus cavity enlarges at the same time as the damage to the maxillary bone. Thus, the surgeon is forced to resort, in addition to bone addition, to another special procedure, called sinus lift.

Another particular situation is when the jaw bone is not wide enough for implants to be inserted. The procedure that solves this case is called Increasing the Maxillary Crest.

As in the classic bone addition, the bone graft can be added in a small proportion on the edge of the narrow jaw to enlarge it. Sometimes, the dental implant can be inserted immediately after the increase of the jaw crest, other times it takes long periods of time (4-12 months) for healing and osseointegration to be achieved.