When a tooth does not develop, the alveolar bone that would have supported it does not form completely. The result, at the agenesis site, is frequently a narrow ridge, with predominantly horizontal atrophy. This is the central technical difficulty of the implant in these cases: the bone thickness may not be enough to receive and to support the implant over time.
The conventional route: the graft
To regain thickness the conventional route is regeneration with a bone graft (autologous harvest from a second site, or heterologous or synthetic materials) and often membranes. Outcomes are documented and reliable, but they involve a second surgical site or the introduction of biomaterials, a more complex biology and longer times.
An alternative, in selected cases: the MTM approach
Morphogenic Tissue Management aims at bone and muco-periosteal regeneration in cases of predominantly horizontal atrophy, without grafts, membranes or heterologous materials, using the biological signals present at the site during implant placement. It is not a universal solution: it is an elective procedure, indicated only after a clinical, radiological and instrumental assessment confirming adequate biological conditions. In the presence of severe atrophy, uncontrolled systemic factors or compromised vascularity, the graft remains indicated.
The concrete differences between the two routes, on the operative, biological, economic, time and prognostic level, are in the dedicated article and on the MTM implant dentistry page.
Related reading
- Agenesis and MTM
- MTM in implant dentistry, Rome
- Dental implants in Rome
- Tooth agenesis: what it is and how it is treated
References: alveolar bone deficiency PMC11422703; site regeneration PMID 7751111, 18991003. Informational disclaimer. Author: Dr. Gaetano Calesini.