Adriana asks:
I am a patient requiring an implant on #8. I had a crown placed on this tooth due to trauma when I was 10 years old. The crown lasted 25 years, but now what's left of the tooth has broken - thus necessitating the implant. I will require an extraction, but otherwise am in excellent health - no smoking, adequate bone structure, etc.
I understand that you cannot answer questions about my specific case without a clinical examination, but am interested in hearing your general comments. I am very much in the public eye and do a great deal of public speaking so I am looking for a "solution" that will not cause me embarrassing. Any help you can provide would be appreciated!
These are my questions:
1) Is immediate loading a possibility in a case like mine or would a more conservative approach be preferable?
2) Typically, how long do you have patients in a situation like mine wait before loading?
3) If immediate loading is not possible, what temporary solutions have worked best for your patients?
Hi Adriana,
Excellent questions. As you mentioned, I cannot answer questions about your specific case without a clinical examination, but here are my general comments for your specific questions.
Immediate Loading:
It depends upon several factors such as how your teeth meet together, if there has been damage to the bone around the tooth, your esthetic demands, etc.
Waiting Time:
It depends upon the need for grafting as well as the type of implant used and bone quality. The range typically varies from no time to 6 months.
Other Alternative Solutions:
Typical temporary solutions can involve something that looks like an orthodontic retainer that has a tooth on it (but no wire across the front) or a clear retainer with a tooth in it. Some patients may also have a tooth “bonded” to the adjacent teeth during the healing period.
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Dear Adriana: You have a common question that many patients face today. Dental implants have given new hope for better treatment and, at the same time, dental implants require a great deal of experience in treatment planning by dentists. A dental implant is not fool proof and the first thing I look for in my patients is "why" was a tooth lost. There are usually more factors than are apparent. The overall occlusion or meshing of the teeth and wear factors are very important to address The space or volume of bone available and the volume available for the new crown are critical. These volumes can only be determined by a CBCT scan. Front teeth are the most problamatic to restore with a dental implant. There should be no immediate function and there are very few cases that should have delayed function (meaning a temporary is attached to the implant immediately). Volume and quality of bone can only be determined via a CBCT. Implant placement is a long and expensive process. This is not a time to cut corners to save a little. CBCT diagnosis is the place to start.
Sincerely
Dr. Smith
Dr. Leonard H. Smith
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