The Inside Story on Dental Implants
After having a tooth removed, patients sometimes ask how quickly I can replace it with a dental implant. Television, radio, and Internet sources often describe “same day” implants so there is a natural expectation that I’ll be doing that. I can surely provide a “same day” implant, but there are times that I will decide to wait or suggest alternatives to ensure you have the best long term solution for a lost tooth. In this post I’ll cover some of the issues I consider before suggesting to a patient that we proceed with a “same day” implant.
A successful dental implant will provide you with a replacement tooth that is stable, aesthetically pleasing and functional. Achieving a successful outcome requires that a number of factors be carefully considered before I decide to proceed.
The most significant factor that dictates this decision is whether there is enough bone present. Frequently the tooth is being removed due to destruction of the supporting bone, usually caused by periodontal or gum disease. The bone can be assessed best by a 3D cone beam scan, which we perform at Timberlake Dental with our Galileos system. These 3D scans are superior to traditional 2D radiographs which provide a partial view of the bone structure and sometimes miss problems that can be detected with a 3D scan.
Once my examination of the scan has indicated that the bone is healthy enough to support the implant, I look at the surrounding gum and bone (hard and soft tissues). This is primarily important when cosmetics are a high priority, such as with a front tooth. The soft and hard tissues surrounding the future implant site need to be healthy and relatively thick for the best esthetic results.
Then I evaluate the bite (occlusion) of the patient. It is very important that the unique way in which each patient chews and bites be examined – to make sure that the future implant is not subjected to unfavorable direct or twisting forces from other teeth. These forces can quickly lead to failure.
Then I make sure that the positioning of the teeth surrounding the future implant site won’t interfere with the placement of the implant. The surrounding teeth need to allow enough clearance for both the use of instruments and for proper placement of the implant itself.
The next issue is the overall condition of the teeth and gums. If active disease or bacteria are present we may have to wait until that is corrected before proceeding with a new implant.
The last factor is overall health. We have to make sure that no systemic disease is active that may impair healing of the implant. Diabetes, for example, if it is not under control, slows down the healing process.
This is not a complete list of the critical factors for an implant, but will perhaps help in understanding the issues we will address if you need an implant. By addressing these issues I can proceed with an implant with the confidence that it will be successful, whether we finish it in one day or sometime later as the situation demands.
Dr. Rodney D. Chowning, DDS, Denton, TX