Having an implant may consist of approx 4 appointments, the first being a consultation to decide exactly what treatment is best for you. The second appointment is the implant which is a small screw that acts as a tooth root and is placed in the jawbone then an abutment is fitted on the top. The final appointment is a few months later when a crown, bridge or prosthesis is fitted. Having implants is the best solution for replacing missing teeth.
When looking to have an implant it is best in the first instance to book an implant consultation with a dentist where an individual treatment plan can be compiled with a complete cost breakdown. This treatment plan will provide details of all work that needs to be carried out as a series of appointments, including detailed information regarding implants, what the procedure involves and the recovery time expected. This information can be taken away at the end of the consultation by the patient to read and to ensure they are completely happy and confident with the treatment that is planned for them.
Q) A patient was referred to me who had her maxillary left central incisor removed about one week ago by another dentist. The area is healing well and the alveolar ridge and buccal plate are intact. Should I place the implant now or should I wait 3-5 months for healing ? I want to place a Nobel Biocare Replace tapered 3.5 x 10 mm fixture and then I will then place a temporary abutment and temporary crown. What would be a good solution ?
A) That is a interesting question and one that occurs very frequently. I would suggest that you consider placing an implant as soon as possible. The literature shows that once a tooth is removed large amounts of bone are lost especially in the first month. Provided an adequate implant is placed i.e one that fills the space sufficiently and is grafted if necessary there is less chance of bone resorption. I also personally think that a replace narrow platform implant of 10mm is insufficient to replace even a small central incisor tooth. I would not recommend that you load this implant immediately as this is the second smallest implant in the range and unsuitable for a central incisor crown.
Q) I have recently had a new patient referred to me for an implant in the maxilla. The patient has lost 6mm of vertical height, has 7mm of ridge width and 7mm of residual height below the sinus. Would you recommend a direct or indirect sinus lift and which technique would you suggest?
A) If the patient has 6mm of vertical bone loss, despite the amount of bone placed in the sinus cavity, the final restoration will be incredibly difficult to keep clean from plaque and small pieces of food which may lead to periodontal issues if not cleaned vigorously after every meal. If this was my patient I would attempt to construct bone onto the existing ridge to eliminate the 6mm space. If it is possible to create up to 8 or 9mm you may not even have to lift the sinus at all.
