WOULD YOU LIKE TO HAVE IMMEDIATE FIXED TEETH ON YOUR IMPLANTS, TOO?!
Where can you turn? What are your options? What are the pros and cons?
In cases of complete edentulism, the bone is rarely preserved in its entirety. If it is not due to periodontal disease, then the long-standing absence of teeth causes bone resorption.
The result is the same: a limited supply of bone.
There are two schools of thought—scientific and clinical—regarding the treatment of complete edentulism. The dental profession as a whole aligns behind these approaches, led by scientists and leading experts. Half of the implantologists support one approach, while the others support the other…
In my opinion, the question of whether to treat a case with or without bone grafting is most relevant in cases of complete edentulism—these are the two schools of thought. Both sides have valid arguments, methods, advantages, and disadvantages. However, when there’s only a single remaining tooth, which limits our options in many ways, I prefer bone grafting in that situation.
With 32 years of experience in implantology, I can say that I have extensive expertise in both „schools” described below; our clinic is well-equipped and prepared for both.
But what’s most exciting to me right now is that I’ve learned a lot in recent months about techniques that avoid bone grafting… from their history and the results of scientific follow-up studies to the wealth of experience behind even the latest solutions.
This is a case involving a 68-year-old woman that was resolved with bone grafting two years ago. All of her upper implants, which had been placed elsewhere, had to be removed due to massive bone defects… Huge bone grafts were placed in their place… and then we placed 6 implants in the upper jaw and 5 in the lower jaw.
4 surgeries, 18 months of treatment.
A case we had several years ago—essentially the simplest method of avoiding bone grafting: placing the implants in such a way as to establish a balance between the existing bone and the statics of the dental prosthesis.
1 postoperative immediate fixed temporary bridge.
This was a case we had a few months ago. Due to extensive bone loss, the patient had already sought treatment for this problem at numerous other clinics—even in Germany. It was important to him to have teeth right away, without having to undergo a lengthy bone graft procedure…and we ended up being the „winners”…
The surgical techniques for placing the implants circled in green (so-called paranasal) and red (pterygoidal) are specialized and can be learned in separate courses.
In 2014, I was the first person in Hungary to complete the procedure and receive a Zygoma Certificate. This was our very first case in 2014 involving two Zygoma implants. The CT scan was taken during a follow-up in December 2025, and everything is still perfect today. We loaded the implants immediately after surgery.
Pros and Cons
The advantage of bone grafting is…: Implants placed in a straight line in a more ideal position. The disadvantages include 3–4 surgeries, a lengthy treatment process, a high complication rate, and higher costs.
Without bone grafting…advantage: Quick, a single surgery, patients can usually resume physical activity immediately, less expensive, lower complication rate.
The only drawback is relative: it has been proven that angled implants up to 45 degrees do not pose a disadvantage; and with the use of additional components, a less-than-ideal position can be compensated for very effectively.
Both have a similar lifespan; today, we estimate it to be 20–40 years.
