Never say never: the impact of dental technologies on biologic ridge deficiencies

Dr. Daniel Fenton provided cost-effective implants to this patient who thought she would never be able to afford them. Read how he provides individualized patient care for her and others.


”I’ve been to five other dental offices, and all have said I don’t have enough bone for dental implants, so I guess I’ll just have to deal with these loose dentures for the rest of my life,” solemnly explained 79-year-old Ms. Mary. Embarrassed and disappointed, she sank deeper and deeper into the dental chair during her consultation visit. However, as a new patient to the practice, she was required to undergo a radiographic examination. Consequently, her CBCT scan illustrated bilateral severe mandibular atrophy with diminished soft tissue keratinization and, consequently, a protrusive Class III malocclusion.

I entered the room, thoroughly assessed her 3D imaging, turned to Mary, and unequivocally asserted that it was possible to place dental implants, and all she was required to do was decide whether she wanted two or four of them, and if she wanted her new teeth to be fixed or removable. Her conviction that dental implants were a mere impossibility had vanished faster than her eyebrows raised in disbelief upon hearing my assessment of her periodontium.

Novel technologies, techniques, and ridge-specific implant fixtures are to thank for increasing patient candidacy for patients like Mary. The use of 3D imaging — in conjunction with implants of unconventional diameters, heights, tapers, and thread designs — is now utilized to achieve optimal prosthetic outcomes and increase the quality of life for patients who struggled to smile, speak, and/or function.

Shorter, wider implants like the BioHorizons® Tapered Short portfolio or the Neodent® 5.0 mm x 8 mm GM as well as taller, narrower fixtures like the BioHorizons 3.0 mm x 15 mm or the Zest Dental Solutions® Lodi 2.4 mm x 14 mm allow for dental implant placement to accommodate for compromised bone volumes. The bony topographies most applicable to receive the aid of these ridge-specific implants are reflective of the Lekholm and Zarb Classification Types D and E (height deficient) as well as the Seibert Type I ridge defects (width deficient). Often the surgical intervention with these dental implants is minimally invasive with use of smaller/no-flap reflection that preserves diminished attached epithelium, facilitates immediate loading of provisional prostheses, and mitigates postoperative discomfort.

In turn, due to the limited bone volume of these patients, this faction of dental implants not only requires significantly accurate placement to avoid vital structures, but also must predictably exist in locations that result in restorative longevity. In turn, guided and/or semi-guided surgery protocols and workflows are an advantageous adjunct to the scrupulous nature of these surgeries.

Most notably, the service bestowed upon the patient is a truly life changing. Regardless if the dentition is implant retained or implant supported, the positive impact made on patients’ lives by employing these exceptional modalities results in happier and healthier individuals.  Those individuals fortuitously turn out to be both the doctor and patient — I would beg to differ with Ms. Mary, which one of us felt the greater sense of gratification following the completion of her transformation!


Dr. Daniel Fenton

To find out more about providing cost-effective implants through training with Affordable Dentures and implants, read this practice profile:

Daniel Fenton, DMD, FAGD, AFAAID, DICOI, is a 2010 graduate of Nova Southeastern University College of Dental Medicine. He has Affordable Dentures & Implants practices in Port St. Lucie and Miami Lakes, Florida, and is faculty at Implant Pathway in Scottsdale, Arizona. Dr. Fenton holds Diplomate status within the International Congress of Oral Implantologists, Misch International Implant Association, and International Dental Implant Association, as well as Fellowship status within the Academy of General Dentistry, American Academy of Implant Prosthetics and Associate Fellow within American Academy of Implant Dentistry.​

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