Never had a lower left bottom molar, do I need a dental implant?

Question

I never had the lower left bottom last molar (or wisdom teeth there) and now my dentist is recommending a dental implant.  The upper tooth has already been infected and we are addressing that issue with a root canal and crown.  My question is since I've been living without it my entire life (I'm 32) and don't miss it, and the teeth on top are being taken care of, do I really need a dental implant?  Will there be other negative effects on my mouth if I don't get an implant?

Answer 1

In my opinion there is virtually never an indication for the replacement of a wisdom tooth. Even 2nd molar replacement is complex due to the neuro-vascular channel which is in intimate association with that area. This is an anatomical structure which is more prone to damage the further back an implant placement is considered. Complications include complete loss or altered sensation in the lip, chin & dental structures on the effected side. Also lack of bone quantity & quality creates extremely low tolerances for implant placement, increasing risk of perforation of surgical site & lack of support.

There are of course those, extreme exceptions but this area is usually trouble for Dr & patient. My advice in this case is removal of the antagonistic upper wisdom tooth and not to proceed with implantation of any 3rd molar area.

Michael E. Corsello DMD
Pittsburgh, PA
www.northlanddentalimplant.com/
412-367-7400

Answer 2

If you are missing #17 (mandibular left wisdom tooth) and want #16 (maxillary left wisdom tooth) to be fully functional, you would get #17 implant.  If #16 is occluding with #18 (mandibular left second molar), it will probably not extrude and you can function without #17.

Answer 3

The decision is all based on your bite, amount of space available, and whether or not placement of a dental implant makes sense. Replacement of third molars with implants is usually not recommended as they are difficult to do (due to lack of space) and clean. Replacement of second molars is recommended as long as your bite and functional requirements allow it.

Dr. H Ryan Kazemi
Bethesda , MD
www.facialart.com