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).
Answered by: Dr. David R. Edenbaum Marlton, NJ
Website: http://www.stateoftheartsmiles.net
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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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