Anatomical Hazards

In the upper jaw an obstacle to placing implants is presented by the maxillary antrum (sinus) which is a cavity in close proximity to the upper posterior teeth. In some cases following extraction, there is insufficient bone below the sinus to replace missing premolars or molars. If implants enter the sinus, infection, lack of stability or poor healing may result. Some patients elect to have a “sinus lift”.  This is an operation which lifts the membrane of the sinus (Schneiderian membrane) and places bone below it.  The bone can be harvested from the iliac crest of the hip (a separate operation under general anaesthetic) or artificial bone granules or powder can be placed. Although often successful, this operation costs about £2,000 per antrum and requires a lot of commitment from the patient.

There are no major nerves in the upper jaw to harm within the alveolar (jaw) bone.  Placing implants in the anterior region of the upper jaw to restore missing incisors is very predictable and relatively hazard free.

In the lower jaw there is the inferior dental nerve, a major sensory nerve, which must be avoided. This enters the mandible behind the wisdom tooth, traverses the jaw on each side to emerge through a foramen to supply the lip. Damage to this nerve can cause a numb lip. We take great care to stay clear of this nerve by measuring its position and limiting our implant (and drill) lengths to miss it. Full scans are particularly helpful for some of the cases involving the lower jaw but are not imperative for all patients.

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