bone grafting Archives - Hilton Head Cosmetic Dentist

My Implant Teeth Do Not Fit

Posted on October 31, 2026 by writeradmin.

I replaced my front four teeth with dental implants. The whole thing has been a nightmare. The first prototype didn’t fit at all. They didn’t even align with the screws. It took two more prototypes to get them to fit. The final ones changed the whole shape of my face. They’re too far forward. At first I was promised remakes. That never happened. Now that the healing period is done they’re saying I’d have to pay to get smaller ones and they want me to sign a waiver saying that the smaller zirconia will probably break and they told me that. How can this be okay?

Dena

Dear Dena,

I agree that this is a nightmare. I’ve heard many of these stories. Most of them involve a dentist which does not have post-doctoral training in dental implants. This is an advanced procedure and a lot can go wrong. I haven’t examined you but based on your description, it sounds like the problem is more the placement of the dental implants than it is the crowns or bridge that went over them. If your teeth flowed together fine before and weren’t bulky, then it should not have been that hard for your implants to be placed to where they did the same.

What matters now is how to fix it. Ideally, you’d want the implants in the right place. But, once your bone has integrated to the implants it becomes more complicated than simply replacing them. You’d have to remove those, then have bone grafting done before any replacements can be done. This is because the removal procedure takes bone with it. Bone you need in order to retain the implants. Then, once that is healed you can replace the implants and start again.

A second option would be to get a custom made abutment that can move the angle of the implants. Custom made abutments cost more than the standard ones, but it could prevent you from needing more surgery. My recommendation is that you speak to an AACD accredited dentist, who also has dental implant training. They can give you the right solution to get your face back and ensure your new teeth are in good shape.

This blog is brought to you by a top-rated dentist in Hilton Head, Dr. Bonnie Rothwell.

Sinus Perforation from a Dental Implant

Posted on October 31, 2023 by writeradmin.

I have a couple of questions about a sinus perforation that happened during my dental implant placement. First, should it have happened? My dentist said this is fairly common. It went a few millimeters into the sinus cavity. Second, did my dentist handle this correctly once it happened? About six months into my procedure, the dentist realized that the area was not filling in correctly and he suspected bone loss. He removed the implant. He said there was no infection because there was no bone there. Because of that he said I would not need an antibiotic. He told me he did not repair it but cleaned and stitched the area and told me it should heal on its own. Then in a year we can start again. He also told me to take Flonase and not blow my nose. The week or two following, I had a problem with crackling and some mild pain. I felt like it was getting infected. He reluctantly agreed to give me an antibiotic. Thank you for any guidance you can give.

Morgan

Dear Morgan,

There are a few issues here. I think following the perforation was handled okay. However, the perforation itself and the fact that there was no bone integration are serious issues. While there are some occassions that a sinus would be perforated, it is certainly not common and definitely not by several millimeters. In dental terms, that is a HUGE amount. This should not have happened. I’m curious as to what type of diagnostics he did before your dental implants procedure. A CT scan would have shown him the complete layout of the area and prevented the perforation. It also would have told him if there was enough bone structure to support the dental implant.

Before you allow your dentist to start over, I think you should find out exactly why the first one failed. Be aware that you will also need some bone grafting done before you procede with the procedure a second time. Aside from the missing bone you already had, the area where the dental implant was will need bone to be filled in to the area.

Make sure, if you stick with this dentist, that he does adequate diagnostics to prevent these problems a second time.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

A Case of Dental Implant Incompetence

Posted on May 26, 2023 by writeradmin.

I had a dental implant placed. A week or so ago, everything felt a bit loose. I called the dentist and he had me come in and he did an x-ray. He said the dental implant itself was fine and the problem was likely just that the dental crown was loose and needed to be recemented. I was relieved, to say the least. The real problem I ran into was when the dentist tried to rebond the crown. He tried to take it off, but the crown wasn’t budging. He got a special tool to help him, which did eventually get the dental crown off, but when it came off the dental implant came with it. I don’t know why this happened. Is is still possible to get a dental implant or is this a done deal and I need to look for something else?

Kaylie

Dear Kaylie,

I am sorry this has happened to you. I am having trouble understanding this level of gross incompetence. It should have been more than obvious it wasn’t your crown when he couldn’t get it off easily. A loose dental crown will come right off. His not recognizing that caused him to yank out your dental implant.

He should not have been able to yank that out easily if it were a secure dental implant. This tells me that the implant had failed. This does not mean that you cannot have another dental implant placed. I just would not recommend you do it with this dentist. There are several reasons for dental implant failure.

One could be that the dentist placed the crown well before the bone had time to properly integrate with the implant. Another possibility is that there was never enough bone there to support the implant to begin with. There is also the possibility of infection, but that is usually accompanied by a fever and some pain.

In your place, I would ask for a full refund. Then, if you still want a dental implant as your replacement, I would go to a dentist that had a significant amount of post-doctoral training in dental implants. This way you can be assured they know what they’re doing. One thing to note is that before you can have the dental implant procedure redone, you will need to have some bone grafting done in order to build back up the bone that is certainly gone now that you’ve lost the implant. Once that is healed up, you can start the implant procedure.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Antiobiotic for Infected Dental Implant?

Posted on December 26, 2022 by writeradmin.

I have had a dental implant for quite some time, about 22 years. In recent, months it became loose. I went back to see my dentist and he told me the implant is infected. He wants to remove it and said he could replace it with a dental bridge. The teeth next to the dental implant are healthy, so I am not too keen on grinding them down. Is there an antibiotic I can take to deal with this infection and keep my dental implant?

Peg

Dear Peg,

I am sorry your dental implant is giving you trouble but glad that it lasted as many years as it did. Once your dental implant is loose it means that it will fail, so taking an antibiotic will not solve the problem. The damage has already been done, usually in the form of bone loss. That bone is essential to retain your dental implant.

While a dental bridge is an option, it does not sound like one that you are excited about. If you want to, you can get a new dental implant put in its place but it will take some work. First, you will want to deal with any residual infection that is left after you have the dental implant removed. Then, you will need to replace the bone structure that was lost from both the infection and the extraction. You can do that with a bone grafting procedure. Once that is healed, you can then have a new implant placed. That is a lot of procedures, but it will give you back a dental implant.

Other than that, a dental bridge is the next best option, but yes, it would mean grinding down the two healthy adjacent teeth. A third option is a removable partial denture but it will not be nearly as secure as your dental implant was as it is not permanently placed.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Bone Grafting Failed

Posted on December 31, 2021 by writeradmin.

My dentist has done hundreds of dental implants. Because of that, I felt fairly confident that he could do mine without any problems. That has not turned out to be the case. When he went in for the surgery, he discovered there was less bone than he thought. He did not place the implants and told me I’d need some bone grafting. I agreed to that procedure and had a second surgery. Then, it was time for my dental implants again. When he went in, again he felt there wasn’t enough bone and decided I would need to have a dental bridge. I’m very frustrated because I have had three surgeries and no dental implant. I don’t understand why the bone grafting didn’t work. Will I be stuck with a dental bridge?

Eugene

Dear Eugene,

You do have one good thing going for you here. As frustrating as your situation has been, your dentist had integrity. I can’t tell you the number of patients who have come into our office with failing dental implants and after looking at them, it was obvious their dentist placed them poorly or that they didn’t have adequate bone. The dentist had to know this but rather than admit a mistake they just let the patient have a surgery and procedure that was bound to fail. Leaving the patient to wonder why their implants failed. Your dentist would rather you know his procedure did not work than leave you with a failed procedure.

A second good thing about your dentist is he is trying to improve his skills. Some dentists are content just to do the procedures they are comfortable with, but your dentist is trying to learn new technologies and procedures that will help his patients as he improves. We all start somewhere.

That being said, he is still developing his bone grafting skills. It is likely if you go to a different dentist, who is more experienced in bone grafting, that you will be able to get your dental implants. I do not think your dentist will be offended by you going elsewhere for this procedure. Just be sure to check with them how many successful bone grafting procedures they’ve done.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Can I Get Dental Implants After Twelve Years in Dentures?

Posted on October 16, 2021 by writeradmin.

I’ve never been able to afford good anything and that included my dental work. When I lost my teeth, I could only get dentures. It was humiliating but it was all I could do. Now it is twelve years later and I have just come into a lot of money. I mean a LOT. I have always hated these dentures. Is it too late for me to get dental implants?

Callie

Dear Callie,

First, congratulations on your windfall! It says a lot that the first thing you are trying to do with your money is to invest in your health. Now to answer your question. Technically, it is never too late to get dental implants. But, (isn’t there always a but?) the length of time you’ve been wearing dentures will mean that you may need an additional procedure before proceeding.

When your teeth were removed, your body began a process of resorption. Recognizing you no longer have teeth, your body begins to take the minerals that were in your jawbone supporting your teeth to use elsewhere in your body. This is in order to be as efficient as possible with your body’s resources. Somewhere between ten and fifteen years, depending on the speed of the resorption, you may no longer have enough bone to support your dentures. This process is called facial collapse in dental ciricles (pictured left). In addition to the problems it causes with your dentures, it will age your appearance by decades.

In order to retain your new dental implants, you will need that bone back. The good news is there is a procedure that can help you get that structure back, known as bone grafting. Once you’ve done that, after a period of healing, you will be ready to get those implants!

The important thing for you is to find a dentist with post-doctoral training in dental implants. It is an advanced procedure and you don’t want just any dentist. Then, once the dental implants have had time to integrate with your bone, your dentist can anchor a new set of dentures to them. These are known as implant overdentures. Unlike the dentures you’ve had for the last decade, these will be completely secure. You will find your quality of life goes up significantly, including your ability to eat. Even the best fitting removable dentures will reduce your chewing capacity by 50%. That will no longer be true.

I want to mention one other consideration. Dentures can be beautiful, but you will need an expert cosmetic dentist to do that. After you make a list of qualified dentists with dental implant training, I would consider looking at their ability to provide beautiful results. The best cosmetic dentists are AACD accredited, so I’d start there.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Dentist Placed Implants Knowing They Would Fail

Posted on June 6, 2021 by writeradmin.

I went to my dentist about getting some dental implants. He has placed quite a few of them so I felt comfortable with the procedure. After some initial diagnostics, he said everything was good to go. Then, I had the procedure, after which he told me that after he was in there he realized there really isn’t enough bone for them to last. Yet, he put them in any way. Now he is suggesting that we remove them and I get a dental bridge instead. Can he do this? Part of me feels like I should get a refund.

Luke

Dear Luke,

No, he can’t do this, nor will you have to get a dental bridge. When a dentist places a dental implant, there is an implied warranty that he believes it will stay in. He has already admitted that he knew it would not hold together but placed it anyway. He can’t do that. Essentially he did a surgical procedure on you knowing it would fail. If he had told you that, I sincerely doubt you would have gone through with the procedure. Not to mention that any type of medical procedure always carry risks with them.

Additionally, this was completely preventable. You said he did some initial diagnostics. That is what they were for; to see if you had enough bone support and were a good candidate for dental implants. Either he didn’t do adequate diagnostics or he has no idea how to interpret them. Either way, it is essentially malpractice.

In your place, I would tell him that you want him to pay for the bone grafting that is necessary for you to have a successful dental implant procedure and the dental implants and procedure as well, with the dentist of YOUR choice. Then, I want you to find a dentist with post-doctoral implant training and a high success rate.

If he agrees to that there is no need to take this any further. If he doesn’t, then tell him you will speak to an attorney and you will likely get all of that plus more for your time as well as the risk and trauma he put you through. What your dentist did is inexcusable.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Titanium Versus Zirconia Dental Implants

Posted on August 12, 2020 by writeradmin.

I’ve recently been looking at alternative health sites to try to get a better grasp of my health. In one article I recently read it indicated that recent studies have shown that metal in the body can cause neurological ill-effects. I have two titanium implants. Should I switch them out for the newer zirconia implants?

Kelly

Dear Kelly,

I’d be very interested in seeing that article. My guess is they didn’t actually document which “studies” showed these results. I sincerely doubt they had any scientific integrity. Let’s start with the idea that metal in the body can cause neurological ill-effects. Our bodies naturally have metal in them. In many cases, those metals are necessary to sustain our lives. Just one example would be iron. There is iron (a metal) in our blood. Without enough of it, we become anemic which can be life-threatening. Metals on their own are not dangerous in our bodies, depending on the type of metal.

With that in mind, let’s look at the specific metal you are referring to in regard to your dental implants. Titanium is highly biocompatible and have been used as biological replacements for decades, including such things as hip replacements. There have been no studies, as far as I am aware, that show any neurological problems as a result.

Zirconia is becoming more readily available for dental work and is a great advancement. It is especially helpful to give patients a metal-free option for dental crowns on their back teeth because it is so strong. If you were ever to need any additional dental work, getting it done with zirconia would be a fine option.

Should You Replace Your Dental Implants?

That being said, I don’t feel like I can recommend you replace your current dental implants unless there was a problem with them. To do so, would mean you are removing healthy implants. When you remove them, it will also take bone structure with it. That bone structure is necessary to integrate and retain the new implants. This will require you to need some bone grafting done in order to have enough bone again. Now you have added an additional procedure.

Let’s say all that goes fine. None of that guarantees the new implants will succeed. So now you’ve taken out viable implants, added an additional procedure, and have to hope the second set will fare as well as the first. To me, it seems like totally unnecessary expense and risk. Though I’m sure you would be able to find a dentist willing to make money off of it, I am going to recommend you save your time and money and just keep the implants you have.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Key Factors in Dental Implant Failure

Posted on August 14, 2019 by writeradmin.

I am getting some dental implants done. I’ve had tons of x-rays done, but now my dentist wants to do a CT scan. Is this really necessary or is he just padding on the cost of tests? I have one other question while I’m asking things anyway. I have another dentist I can use that doesn’t require CT scans, but he uses a brand of implant called Venturi. I can’t find out much information on that brand. Does that matter?

Casey

Dear Casey,

Dental implant with crown

You’ve asked some important questions. I’ll start with the CT scan. This is actually an important part of the dental implant process. It’s a good sign your dentist is asking for one. Placing dental implants is a 3-Dimensional procedure. While, as you already know, you can find a dentist willing to place them without the scan, it is not for your benefit.

Your upper teeth are quite close to your sinus cavities. It is very easy for you implants to be placed too far and perforate your sinuses. To avoid that, some dentists will use shorter implants so they don’t risk hitting the sinus cavity. Unfortunately, these don’t always hold up as well. If it fails a year later, you won’t know why.

I recommend doing the CT scan. Not only can it prevent the perforation, but it also helps the dentist to know if you have enough bone density in your jaw to sustain the implants. If there’s not, you’ll need some bone grafting to ensure you’re a good candidate.

Do Dental Implant Brands Matter?

Your second question is also important. The quality of the dental implant has a huge impact on the success of your procedure.
I don’t know much about that particular manufacturer, which does have me concerned. Most of the top implant dentists will use one of the following brands because they have good quality control.

Straumann
Nobel Biocare
3i
BioHorizons
Zimmer
Astrotech

The fact that the second dentist you are considering is not using one of these brands, on top of the fact he doesn’t require a CT scan makes me quite leary of his work.

This blog is brought to you by Hilton Head Dentist Dr. Bonnie Rothwell.

Dental Implant Loose After Two Years

Posted on May 30, 2019 by writeradmin.

When I agreed to get a dental implant they told me it would last many years. I’ve only had it for two years and it is already loose. Should I still have to pay for it? Do I get a new one when it falls out for free?

Kurt

Dear Kurt,

An illustration of three dental implants at various stages of crown placement

When maintained well, dental implants can last for many years.

Before anyone panics, I want to recommend you let your dentist know what is going on. Yes, dental implants should last for many years when properly placed and well maintained. That being said, sometimes both you and the dentist can do everything right and a body will still reject the implants. Each person’s body responds to an implant or medical procedure differently.

Just because yours feels loose doesn’t mean it is going to fail. However, it does need to be looked at right away. There are a few reasons why it could feel loose and it may not even be the implant itself which is the problem.

The easiest issue would be the dental crown is loose. In this case, it is just a matter of the porcelain crown being bonded on again to secure it. Another problem could be the abutment. If that is faulty, your dentist could talk to the manufacturer and get it replaced at no cost to you.

If the implant itself is loose that is more serious. There are a few reasons an implant can come loose. An infection is often a problem. With any surgical procedure, infection is a risk. The sooner you see your dentist, the sooner he can start you on antibiotics and try to save the implant. Another reason could be it doesn’t integrate with the bone. You are at a greater risk for both of these problems if you smoke. Finally, it could come loose because of a faulty placement. If you can prove that, then you can get a refund.

If a Dental Implant Fails

When done properly, dental implants have about a 98% success rate, but as I mentioned earlier, even the best procedures can fail. When that happens you have two choices— you can use a different tooth replacement or you can start over and try again. If you are getting a single dental implant, a dental bridge is a perfectly good substitution option.

If you want to try for a dental implant again, you will need to have some bone grafting done to make sure there is enough bone there to support the new implant.

I hope this helps you. This blog is brought to you by Hilton Head Dentist Dr. Bonnie Rothwell.

Monday	8:00-5:00
Tuesday	8:00-5:00
Wednesday	8:00-5:00
Thursday	8:00-5:00
Friday	Closed
Saturday	Closed
Sunday	Closed