Dental Implant with Bone Loss: Is It Possible?

Solutions With or Without Bone Grafting in Schiedam

Written by Danilo Di Vico — Dentistry and Digital Implantology at 3D Tandarts Schiedam – Last updated: June 2026 –

Many patients are told that they have “too little bone” for dental implants. In reality, this often does not mean that an implant is impossible.

At 3D Tandarts in Schiedam, located at Schiedam Centrum Station, modern techniques such as 3D scans, bone grafting and digital planning allow us to place implants in many cases even when bone loss is present.

The only way to know for certain is through a personal assessment.

What Is Bone Loss?

Bone loss in the jaw occurs when the jawbone gradually decreases in volume. This often happens after:

• the loss of a tooth or molar;
• long-term use of a complete or partial denture;
• periodontitis (gum disease);
• infections in the jaw.

Because this process occurs gradually, many people only notice it at a later stage.

Why Is Sufficient Jawbone Important for a Dental Implant?

A dental implant needs to integrate firmly with the jawbone in order to remain stable and function for many years. For this reason, we assess not only the amount of bone available, but also its quality afififififififind the location where the implant needs to be placed.

The assessment includes factors such as:

• the height and width of the jawbone;
• the density and quality of the bone;
• the distance from nerves and the maxillary sinus;
• the position of the future crown or bridge;
• the possibility of keeping the implant properly clean.

The goal is not simply to place an implant, but to achieve a predictable and durable long-term result.

How Do We Determine Whether You Have Enough Bone?

How is this assessed in practice?

Assessing bone height, nerves afififififififind the position of the future crown is not based on estimation alone, but on a structured digital planning process.

1. 3D Scan of the Jaw (CBCT)

A CBCT scan of the jaw is taken.

This provides a three-dimensional view of:

• the exact amount of available bone;
• the course of the nerve;
• the position of the maxillary sinus;
• any bone defects.

This forms the basis for further planning.

1. Digital Implant Planning

Using specialised software, the implant is virtually positioned. This is part of computer-guided implantology, in which the position of the dental implant is digitally determined before the actual procedure and is often transferred to the mouth using a surgical guide.

During this process, we determine:

• the optimal angle and position of the implant;
• the available bone height and width;
• the distance from nerves and the sinus;
• the relationship with the future tooth position.

This makes it possible to determine in advance where the implant can be safely positioned.

1. Prosthetically Driven Planning

The implant position is determined by the final tooth, not the other way around.

For this reason, we plan in advance:

• the shape and position of the crown or bridge;
• the functional bite;
• the aesthetic relationship with the surrounding teeth;
• the possibilities for maintaining good oral hygiene.

This is also known as prosthetically driven implantology.

1. Translating the Plan Into the Surgical Procedure

The treatment is performed on the basis of the digital planning.

Depending on the situation, this may be done:

• using a surgical guide;
• using a digitally planned freehand technique;
• sometimes in combination with bone grafting.

This allows the planned implant position to be transferred accurately to the mouth.

Why Is This Important?

The goal is not simply to place an implant, but to achieve a predictable and durable result that:

• functions correctly;
• looks natural;
• remains easy to clean;
• remains stable over the long term.

When Is an Implant Possible Without Bone Grafting?

An implant can often be placed directly when:

• the tooth has not been missing for a long time;
• sufficient bone volume is available;
• there is no active infection;
• the implant position is favourable;
• a stable and easily maintainable result can be achieved.

Even when limited bone loss is present, an implant can sometimes be placed without additional treatment thanks to careful planning.

Bone Grafting for Dental Implants

When Is Bone Grafting Necessary?

When there is insufficient jawbone to place an implant safely and securely, bone grafting may be necessary.

The aim is to create sufficient support so that the implant can integrate properly and be placed in the correct position.

Bone grafting may be considered in cases of:

• severe bone loss after tooth loss;
• bone loss caused by periodontitis;
• a narrow jaw ridge;
• insufficient bone height;
• bone defects following infection;
• insufficient bone beneath the sinus in the upper jaw.

What Types of Bone Grafting Are Available?

Different techniques can be used depending on the individual situation.

With limited bone loss, a small local bone graft may sometimes be performed aroufififififififind the implant.

For larger defects, a regenerative procedure may first be required before the implant can be placed.

In the upper jaw, a sinus lift may also be necessary when there is insufficient bone beneath the maxillary sinus for safe implant placement.

Whether bone grafting can be performed at the same time as implant placement or needs to heal first depefififififififinds on the amount of available bone afififififififind the required implant stability.

What Happens During the Procedure?

The treatment is usually performed under local anaesthesia.

During the procedure, patients generally feel pressure and vibrations but no sharp pain.

Afterwards, mild pain, swelling and tenderness may occur. Recovery after larger bone grafting procedures can be more extensive than after standard implant placement.

How Long Does Recovery Take?

The gums generally heal within a few weeks, while newly formed bone may require several months to heal fully.

During this period, patients are often advised to:

• temporarily eat softer foods;
• keep the treated area clean;
• avoid smoking as much as possible;
• attend follow-up appointments as scheduled.

The implant can only be definitively loaded once sufficient bone healing has taken place.

Dental Implants After Periodontitis

A dental implant may also be possible after periodontitis, provided that the inflammation is fully under control and good oral hygiene is maintained.

Regular check-ups and professional maintenance are important to reduce the risk of peri-implantitis and further bone loss.

Is a Second Opinion Useful?

A second opinion can be valuable if you have previously been told that dental implants are not possible or if you have received different treatment recommendations.

With new imaging and modern treatment techniques, possibilities may sometimes be identified that were not previously considered.

What Are the Alternatives?

Not every situation requires the same solution.

Depending on the amount of available bone and your preferences, options may include:

• an implant without bone grafting;
• an implant combined with bone grafting;
• an implant with a sinus lift;
• a dental bridge;
• an implant-supported overdenture;
• another prosthetic solution.

The final choice depefififififififinds on function, aesthetics, maintenance, comfort afififififififind the long-term prognosis.

What Happens If You Wait?

When a missing tooth is not replaced for a long period of time, the jawbone may continue to shrink.

The surrounding teeth may also shift, and treatment can sometimes become more complex later.

Not every situation requires immediate treatment, but timely assessment can help preserve future treatment options.

What Does a Dental Implant Cost When Bone Loss Is Present?

The final cost depefififififififinds on the individual situation and may include:

• diagnostics; • a 3D scan if required; • bone grafting;

• implant placement;
• the crown or bridge;
• follow-up appointments and aftercare.

A personalised cost estimate is therefore always necessary.

Does an Implant or Bone Grafting Hurt?

Thanks to local anaesthesia, you should not experience sharp pain during the procedure.

Afterwards, mild pain, swelling and tenderness are normal and usually temporary.

Most symptoms gradually decrease during the first few days after treatment.

If you would like to learn more about this subject, you can click here.

When Is a Dental Implant Less Suitable?

A dental implant is not always the best solution.

This may be the case, for example, with:

• active periodontitis; • inadequate oral hygiene; • certain medical conditions; • risk factors that may affect bone healing; • situations requiring very extensive reconstruction.

In these situations, a bridge or implant-supported overdenture may be a better option.

Conclusion

Bone loss does not automatically mean that a dental implant is impossible.

Thanks to modern diagnostics and techniques such as bone grafting, many patients with bone loss can still be successfully treated.

The only reliable way to determine which treatment is most appropriate is through an individual examination, including a clinical assessment and, when necessary, a 3D scan.

This allows us to develop a treatment plan that is not only technically feasible, but also safe, functional and predictable in the long term.