At 21D, our approach to dental implants is built on a foundation of safety, efficacy, and long-term success. Over the years, advancements in dental technology and techniques have significantly influenced our treatment protocols, leading us to move away from certain traditional procedures such as bone grafts and sinus lifting. In this article, Dr. Vijah explains why these methods are no longer part of our practice and how we achieve better outcomes through alternative techniques.
The Evolution of Our Practice
Twenty years ago, bone grafting and sinus lifting were common practices across the industry. These procedures were heavily promoted by companies and endorsed by paid key opinion leaders as effective solutions for enhancing implant stability in patients with insufficient bone density. However, despite their popularity, our first hand experiences raised concerns about their long-term viability and success rates.
Challenges with Bone Grafts and Sinus Lifting
One of the critical issues with sinus lifting, particularly in scenarios where the initial bone availability was less than two millimeters, is the significant risk of complications. The pressure and shock from chewing can be detrimental when the implant is placed in such a newly grafted area, leading to a high probability of failure. In fact, in our assessment, the predictability of success in these cases is less than 50% over ten years - a risk we are not willing to take with our patients' health and comfort.

The Tilted Implant Approach
Instead of relying on bone grafts, we have embraced the tilted implant approach, which has been a game-changer in implantology. This method involves angling the implants in a way that maximises the use of the existing bone structure without the need for grafting. It’s not only less invasive but also enhances the predictability and stability of the implant over the long term. Remarkably, 95% of our patients who were previously told they needed bone grafts elsewhere actually did not require them when assessed with the possibility of using tilted implants.
Advantages of Avoiding Bone Grafts
By avoiding additional bone grafting surgeries, we reduce the overall risk and complexity of the implant process. This approach decreases the surgical burden on our patients, shortens recovery times, and, most importantly, leads to more predictable outcomes. Furthermore, it aligns with the original clinical concepts behind the revolutionary All-on-4 dental implant technique, which prioritises efficient, reliable solutions over more invasive procedures.
Our decision to move away from bone grafts and sinus lifting at 21D is grounded in our commitment to providing treatments that are both safe and effective. The shift towards utilising tilted implants reflects our dedication to innovative, patient-friendly methods that ensure optimal long-term results. At 21D, we continue to pioneer advancements in dental care, ensuring our practices meet the highest standards of modern dentistry.
If you are considering dental implants and have been advised that you require bone grafts or sinus lifting, we invite you to consult withour team at 21D. Explore alternative options that may offer safer, more predictable outcomes for your dental health.


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