Immediate Loading of an Implant: Will This Be Better Aesthetically?
Stephanie asks:
My dentist and the prosthodontist I went to, do not agree - one said I should get an Immediate Load Implant, and the Prosthodontist says I could use a bone graft. The tooth #8 has a crack in the back after a failed root canal. There is no bone loss at the apex/root, but I was told there is some ( not sure how much) bone loss. The dentist asserts the immediate load implant will be better aesthetically, and that I still have plenty of bone. The prosthodontist disagrees. Any help would be appreciated, as I am losing time everyday, that my tooth remains infected, though it drains daily ( fistula).
Hi Stephanie,
Immediately loading an implant can be beneficial for esthetics in terms of preserving tissue height and form. However, immediate loading stresses the biologic system more than a staged implant.
If you have fractured root, extracting the tooth, ensuring that all 'infected' tissue has been removed, and placing a graft for socket preservation may provide the most predictable method for implant placement in the case of a draining fistula. The esthetics can be addressed by surgical grafting techniques at the time of implant placement.
I would obtain the opinion of a Periodontist or Oral & Maxillofacial Surgeon who is experienced with issues in the esthetic zone. Once you have that information you can make an informed decision with realistic expectations.
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Immediately loading and implant
Dear Stephanie: if you were in my family, I would do the following: obtain a CBCT (cone beam computed tomography) scan to determine exactly the conditions you have. Any other diagnostic aids are not accurate enough.
This will lead an experienced implantologist to suggest the most "predictable" treatment for long term success.
There is much public awarness these days of dental implants and claims that they can be placed and restored immediately. This is truly only in a limited amount of cases that are carefully selected by experienced dentists. I would select the most predictable treatment which often is bone grafting and waiting. This will give ideal conditions in a few months to predictably place a functional and esthetically pleasing restoration.
If an immediate attempt of placing an implant fails, this can worsen conditions and add much time and costs to your treatment.
Sincerely
Dr. Smith
Dr. Leonard H. Smith
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