Complex Implant Cases: Making Impossible Dentistry, Possible

Has your local practice or dentist told you “no”? Have you been made to believe that your case is too complex, not enough bone or gum and that nothing can be done?

We are often asked to give second opinions on cases such as All-on-Four, sinus lifts, multiple implants, bone augmentations, extreme gum disease.

Sometimes there can be so many dental problems with a patient you may not know where to begin.

Many dentists refer patients to The Gentle Dental because of our implant experience and our skill levels and also some of the more advanced dental technology and equipment at our practice.

Here at the Gentle Dental, we often find that nothing is impossible and that there is always something we can do to help you feel better about a patient’s smile.

Please telephone the practice on 020 8224 7562 and mention that you have a complicated case.

Often one of our dentists is available to call you back and give you his opinion of what can be done. The initial call is free of charge and if we can’t help we are happy to point you in the right direction.

Defining complex cases

The following can threaten the success of an implant:

  • Tooth decay and damage
  • Active periodontitis or gum disease
  • Oral infections and sores
  • Horizontal or vertical bone loss and tooth mobility
  • No adjacent teeth, or those present in unsuitable positions
  • Lack of bone depth

As implant dentistry requires special attention and knowledge in periodontal disease, patients finding the right dentist to trust is extremely important to prevent implants from failing.

Missing teeth can be a serious confidence blow. Many will be aware of the damage one or more missing teeth can do to one’s confidence, but the negative effects don’t stop there, and can even contribute to broader health risks.

How to simplify challenging implant cases

When your case is not properly assessed or a dentist does not follow proper protocol, the chances of your implant failing increase.

They occur due to:

  • Poor dental treatment
  • Misdiagnosis
  • Allowing problems to persist untreated

Lack of jawbone density

Dental implant cases often describe a lack of bone present in the jaw, which prevents the safe and stable placement of implants. Within just six months of losing a tooth, the bone in the jaw can deteriorate – it will never grow back.

Typically when there is not enough bone mass to support the dental implant a bone graft will be required.

The placement of implants during advanced bone augmentations will demand a higher level of surgical expertise and the significant capacity to care for such patients.

Achieving solutions

Our approach to realistic bone reconstruction and regeneration for hard and soft tissues is to provide an adequate amount of time for healing through all the different stages of the process. This is vital.

How we handle these types of cases

bone grafts to restore bone in the jawboneAn intricate case is not just defined by the difficulty of a procedure, but rather the potential issues that can compromise the function, comfort and even longevity of the final tooth or teeth.

The prosthodontic team dedicated to your procedure should be qualified in managing the occlusal scheme, which includes modifications to the vertical dimension and position of your teeth and how these developments interact with existing dentition (if present) and their relationship to the jaw.

The result of a case cannot be easily visualised without extensive diagnostic and treatment planning techniques.

Therefore, the treatment will need to involve multiple stages to achieve desired outcomes as more complications are likely to occur.

Our implant consultations aim to identify any and all the potential issues provided in our diagnosis.

Assessing this in the first stage helps us to build trust with our patients rather than highlighting or discovering these issues as we continue with treatment.

Complexity factors include:

  • Multiple missing teeth and the variety of options: which one is best, not only for the patient but for the expected outcomes, how they will be received and budget
  • Large posts and cores – do we keep them or extract them?
  • Do we try and save certain teeth or consider a full mouth reconstruction?
  • Potential medical problems that could compromise treatment
  • Expectations, limitations and past experiences
  • When more than one specialist is involved
  • Managing gum disease and root decay

Each factor adds additional complexity to the case, with the number of problems increases significantly.

The Gentle Dental, and Dr Ali Rifai in particular, continuously have heavy involvement in treating complex cases, and in the past, has been able to provide long-term success and overall peace of mind.

 Our skills and experience sets us apart

award winning dentist Surrey

Why choose Dr Ali Rifai to treat your complex case?

  • 25 years of skill and experience in implantology, prosthodontics and periodontal work; there is nothing Dr Ali has not dealt with
  • Delivers an understanding approach, which allows him to work with patients to find alternative and effective treatments that suit them
  • Has access to the latest dental improvements, technology and software that provide better, more achievable results that go beyond just promises
  • 98.2% success rate for implant placements
  • Easily can provide long-lasting stable solutions to repair your smile

Complex case studies

  1. Gap/Space Under My Dental Implant Bridge
  2. Complication – Bone Graft is Exposed – Platelet PRF Treatment

One step at a time

We take things at your pace and break our treatment up into stages, which will be agreed upon with you upon drawing up the treatment plan.

This allows our clinicians to properly assess your condition and your ability to cope with these procedures.

If you’re unsure about anything, or would really like a second opinion on your condition, give the doctor a call on 020 8224 7562.

Options for tooth replacement

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“It feels like an absolute blessing to be able to chew food again ‘properly’. I am so thankful…

Mrs Charlton


Fantastic Dentist, I haven't stopped recommending their care, skill and professionalism. The opening times and appointment availability is…

Georgie Sherrard

Dr Ali and his team created a Hollywood smile for me. I am absolutely thrilled. I had horrid…

Caroline Mitchell

I have been a patient of Dr Ali Rifai at The Gentle Dental Practice for a while now…

Jason Hamilton

I am completely delighted with the results of my Invisalign treatment. Thank you so much Ali for all…

Judith Pain

Dr Rifai and his staff have been looking after my mother for several years, she's in her 90s…

Paul Bennett

I had a tooth filling with Ali at The Gentle Dental Practice recently. The finished filling is amazing…

Joshua Beth

I have recently been coming here to have work on my teeth and I’ve enjoyed every moment of…

Kane Sharman

What an amazing dental practice. Everyone is so friendly and helpful. Dr Ali is great and understanding. I…

Ria Winstanley

Ali is an excellent dentist. He also cares very much for patient well being. Ali also went beyond…

lisa clark

Did a great job of straightening my teeth with invisalign treatment!

James Crisp

Amazing service! You can have a crown made whilst you wait, and no more horrible moulds!! Highly recommend…

Domenica Dilieto

I visited The practice for the first time yesterday and had emergency dental treatment. Ali was absolutely brilliant…

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I am delighted to be able to offer my thoughts regarding the dental work offered by Dr Rifai.…

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