Essential Questions About Dental Implants: What You Need to Know

Q: Essential Questions About Dental Implants: What You Need to Know

Hello： 1. If too much time (1-2 years) passes after tooth extraction, adjacent teeth may tilt, resulting in insufficient space for an implant. Therefore, it is best to place a prosthesis as soon as possible after tooth extraction to maintain space. 2. Rega

Dental implant-related issues?

Hello Dr.
Wu, I am a student from Taipei studying in Tainan and I am about to graduate.
I have a cavity in my upper left second premolar that cannot be restored with a crown, and I do not want to use a dental bridge as it would damage the adjacent healthy teeth.
Therefore, I am considering dental implants for treatment.
I have an appointment with the clinic doctor on February 14th for tooth extraction.
He mentioned that his usual practice, which is beneficial for the patient, is to perform the implant surgery three months after the extraction (which would be on May 14th) at a cost of NT$60,000.
After placing the implant, he said it would take five weeks to attach the crown (he mentioned that current technology allows for four weeks, but he does not recommend doing it that quickly).

I have several questions:
1.
Is it less suitable to place an implant in the area where the tooth has been missing for a while? Is the bone quality best immediately after extraction, making it the most suitable time for implant placement?
2.
Is the timeline he provided appropriate? From your previous responses, it seems that it takes about 2-3 months to attach the crown.

3.
Would it be better to see a specialist in implant dentistry rather than a general clinic dentist? Are doctors in large hospitals better than those in clinics, even though the costs are higher?
4.
After getting the implant, will I need to return to Tainan for regular check-ups, or can I see a dentist in Taipei for follow-ups? This will affect my decision on whether to have the procedure done in Tainan.

5.
When is bone grafting necessary? Is the cost included in the NT$60,000 that the clinic doctor quoted, which generally covers the implant and crown?
6.
Do I need to choose between different types of crowns, such as porcelain or precious metal, or is that determined by the doctor?
7.
How does the durability of an implant compare to natural teeth (can it withstand hard foods)? With proper maintenance, how long can it last?
8.
I have heard that the failure rate of upper jaw implants is higher.
What are the reasons for this? Are there any potential complications associated with implants?
9.
If the crown on the implant gets damaged years later, can I keep the implant and just replace the crown?
10.
Since I also have some issues with my first premolar, can I later get a single crown for it supported by the second premolar and canine?
11.
Following up on question 10, would you recommend that I get the crown for the first premolar at the same time as the second premolar implant, or is it better not to damage a tooth that is still usable?
I had poor hygiene habits as a child, and now that I am earning my own money to take care of my teeth, I am particularly concerned about the details.
I hope that after the procedure, there will be no issues.
I have many questions, and I greatly appreciate your explanations.

A-Hong, 20~29 year old female. Ask Date: 2008/02/02

Dr. Wu Jinjun reply Dentistry

Hello:
1.
If too much time (1-2 years) passes after tooth extraction, adjacent teeth may tilt, resulting in insufficient space for an implant.
Therefore, it is best to place a prosthesis as soon as possible after tooth extraction to maintain space.

2.
Regarding the timeline, three months is the typical healing period for bone after tooth extraction.
If there are no other systemic diseases, dental implants should not pose significant issues after three months.

3.
The cost of dental implants varies due to the dentist's expertise and the implant system used, so it cannot be generalized.

4.
It is advisable to have regular follow-up appointments after implant placement, as the oral hygiene standards required for implants are higher than for natural teeth.
Poor oral hygiene can significantly increase the risk of implant failure.

5.
Sometimes, there may be bone loss after tooth extraction.
When the bone thickness is insufficient or there are defects that affect the success of the implant, bone grafting is usually performed, which may incur additional costs not included in the implant fee.
Regarding whether the 60,000 TWD includes the prosthesis, you should consult the treating dentist for accurate pricing.

6.
The standards for the prosthesis placed on implants are generally higher, so the procedure should be performed according to the requirements of each implant system.

7.
The success rate of implants is highly correlated with oral hygiene; with proper maintenance, they can last 5-10 years or even longer.

8.
Implants in the upper jaw are technically more challenging due to their proximity to the sinus, and depending on individual circumstances, bone grafting or sinus lift procedures may be necessary.

9.
The lifespan of the implant and prosthesis cannot be guaranteed, as individual occlusal conditions vary significantly, affecting the implant's longevity.
Whether the implant can be preserved for a future prosthesis also requires X-ray evaluation, and a definitive answer cannot be provided.

10.
Regarding the first premolar, a definitive answer cannot be given without clinical evidence.
However, if the issue is related to the root canal and the treatment is successful, it may be possible to place a single crown without affecting the canine and second premolar.

11.
If there are issues with the first premolar, it is advisable to address them promptly rather than delaying, as having a natural tooth root beneath the prosthesis is generally more comfortable for chewing.
Implants should be considered a last resort.

Dr.
Yang Chih-Jen, Department of Dentistry, Hsinchu Hospital, Ministry of Health and Welfare (responding on behalf of Dr.
Wu Jin-Jun, who is currently abroad).

Reply Date: 2008/02/02

More Info

Dear Patient,
Thank you for your detailed inquiry regarding dental implants. It’s great to see you taking an active interest in your dental health, especially as you approach graduation. Let’s address your questions systematically to provide clarity on the dental implant process and related concerns.

0. Timing for Implants After Tooth Extraction:
It is generally true that the best time to place an implant is soon after tooth extraction, particularly if the extraction site is healthy and free from infection. The bone quality is often optimal immediately after extraction, as the body begins to heal. However, waiting for a few months can also be beneficial, especially if there was significant bone loss or if the extraction site needs time to heal properly.

1. Proposed Timeline for Implant Surgery:
Your dentist's recommendation of waiting three months post-extraction before placing the implant is a common practice. While some practitioners may place implants sooner, waiting allows for better healing and can lead to a more stable implant. The timeline of five weeks after implant placement to fit the crown is also reasonable, as it allows for osseointegration, where the bone fuses with the implant.

2. Choosing a Specialist for Implants:
Finding a dentist who specializes in implants can provide you with a higher level of expertise. While general dentists can perform implants, specialists such as oral surgeons or periodontists often have more extensive training and experience. Hospitals may charge more, but they also typically have access to advanced technology and resources.

3. Follow-Up Care:
Post-implant, regular check-ups are crucial for monitoring the health of the implant and surrounding tissues. You can choose to have follow-ups in either location, but it’s essential to maintain consistent care. If you have a trusted dentist in Taipei, you can continue your follow-ups there.

4. Bone Grafting Needs:
Bone grafting may be necessary if there is insufficient bone to support the implant. This is typically an additional cost, and your dentist should provide a detailed breakdown of costs, including whether the quoted price covers all aspects of the procedure.

5. Choosing the Crown Material:
The choice of crown material (porcelain, gold, etc.) can depend on various factors, including aesthetics, durability, and cost. Your dentist should guide you based on your specific needs and preferences.

6. Durability of Implants:
Implants are designed to be durable and can last many years, often 10-15 years or more with proper care. They can withstand normal chewing forces, but it’s essential to maintain good oral hygiene to prevent complications.

7. Failure Rates and Risks:
Implants in the upper jaw can have a higher failure rate due to the quality of bone and proximity to sinuses. Risks include infection, nerve damage, and sinus issues. However, with proper planning and execution, many patients have successful outcomes.

8. Replacing a Damaged Crown:
If the crown on your implant fails, it is usually possible to replace just the crown while keeping the implant intact, provided the implant itself remains healthy.

9. Future Dental Work:
If your first small molar has issues in the future, it may be possible to use the adjacent teeth for a bridge or crown. However, preserving healthy teeth is generally preferable.

10. Recommendations for Concurrent Treatments:
If your first small molar is still functional, it may be wise to avoid unnecessary procedures. However, if it is likely to fail soon, addressing it during the implant procedure could save time and resources in the long run.

In conclusion, it’s commendable that you are taking steps to improve your dental health. Make sure to communicate openly with your dentist about your concerns and preferences. They can help tailor a treatment plan that best suits your needs. Good luck with your dental journey, and feel free to reach out if you have more questions!
Best regards,
Doctor Q&A Teams
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