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Grafting is to prevent facial changes from collapse or bone resorption (or to add a couple mm to place an implant). After collapse, only a reconstruction can make drastic changes. This would normally be done with a facial reconstructive plastic surgeon and without seeing photos, models and all diagnostic records it is difficult to properly advise.
These are very difficult questions to answer without the proper photos and radiographs. My suggestion is you find a good cosmetic dentist or even an oral surgeon to discuss you options. Good luck to you.
If there is no space, there is no place for an implant. Opening space FOR an implant can be very complicated, so finding the right orthodontist or dentist may be a challenge. This will take considerable time and patience but will be worth it in the end.
The implant screw itself is made of titanium and it's very strong. your bone will probably fracture before the implant itself does. but the crown that's sitting on top and the attachments to the implant can break in trauma. if you are having discomfort you should have it checked for sure.
You now must go back and have the implant evaluated. Pain can be from the implant being slightly mobile in the bone. Implants have zero movement in bone. If this is the case it will need to be replaced.
