Implants... hard facts are needed, not miracle cures!

The most common reason for losing one’s teeth is through periodontal disease. The slow progression of infection around the teeth leads to the bone which supports the teeth to recede, almost like it’s trying to run away from the disease process that is happening further up!

Implants require as much bone as possible to integrate and become part of the body. Historically we always tried to place implants that were as long as possible! So there is a problem!

Replacing the missing tooth through periodontal disease means there is less bone then normal and we want as much as possible!

There are two ways out of this situation. We can now using shorter and wider implants. We now have the 8mm implant and some companies (Bicon) have produced a 5.7mm implant. This means previously where it may not have been possible to have an implant it is now a very real possibility.

The second method is bone grafting, less predictable but is now standard practice. What the bone graft is made of and how its done is a separate story and another blog!

We know today that increasing the width of the bone is much easier and all sorts of claims have been made by dentists to promise to be able to increase the height of bone.

One needs to be weary of these claims. If the most respected researches in the field find it difficult or impossible how does an ordinary dentist/Implantologist do it?

I don’t believe in miracle cures! We need hard scientific facts.

Today the combination of shorter implants and grafting means that there are very few situations where we can’t place dental implants.

The truth about implants in a day...

There is a great move to implants with immediate loading. This is where implants are placed and a tooth is put on the implant immediately. This should not be confused with immediate implants, where a tooth is removed and an implant placed straight away without a period of healing.

This is a great development as it means you can now have instant teeth in day – or can you?

The advantage to both patient and dentist is clear. The patient walks away having had a gap 2 hours or so previously, that is now filled, there are fewer appointments to be made and all the surgery is completed in one appointment.

For the dentist, fewer appointments – may reduce the price of the procedure or increase profit, less time spent, you get paid the full amount so better cash flow. You could think this was a win/win situation?

There are many dentists (YouTube is a wash with gory videos) who provide this treatment but little is said about the increased risk of failure, little is said about how much more difficult it is to do this kind of treatment, and little is said about the unpredictable changes in the soft tissues (gum part) and hard tissue (bone).

When a tooth is taken out everything recedes, gums shrink and the bone resorbs and drops down. So one has to estimate this, when aesthetics are not important – it’s not a big problem and in some cases where the bone and gum is the thick type (biotype) shrinkage is minimal and immediate loading is predictable/desirable.

How often do we get patients like that! – Not often enough! Patients need to be careful and not carried away with all the razzmatazz of having something that sounds like its instant, new and exciting.

When a very short wait for healing and then putting a tooth on might sound boring, slow and a wait might in the long term be a better more predictable outcome.

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