Diagnosing and Treating a Hollow Jaw

Recent concerns have occurred in implant complications relating to the “hollow jaw” highlighting the need to diagnose this condition prior to implant surgery.

While the mandible can actually be hollow, as in filled with air, the most common condition is a jaw filled with soft tissue devoid of mineralized tissue. When implants are placed into these areas, the implant can literally fall into the mandible due to lack of resistance. Soft tissue in jaw that lacks mineralized tissue has been termed “hollow jaw”.

A hollow jaw can often be diagnosed and treatment planned to avoid complications and provide predictable implant success. The most valuable aid in diagnosing this condition is a high quality digital periapical radiograph. A dental CT scan or non-digital periapical radiograph, lacks the image quality to make this diagnosis. When cancellous bone lacks mineralized trabeculae, there is a resulting compensation by the cortical bone increasing in thickness. The alveolar crest normally does not have cortical bone. When detecting cortical bone on the crest of alveolar bone, you know there is trouble below in the cancellous bone.