The majority of our Denture/Implant patients have had their Dentures for over five years. In most of these cases implants are a good option. The limiting factor is the amount of bone present, and of course your physical health.If adequate bone is present and you are indeed a candidate for implants you can have them all placed at one visit. Once the implant restoration is completed you will be ecstatic as to how good the retention is and how well you can now eat. Its the ultimate in making Dentures a positive experience
First of all, mini dental implants have a long proven track record as a successful restoration. However, every patient and every situation requires a full analysis of the situation in order to determine which implant will best suit the restoration (denture, crown, etc).Placed correctly a mini implant can support a removable denture or even a fixed (cemented) bridge. Basically we choose an implant based upon the available bone. In our office , we will use the largest sized implant possible based upon the bone width and bone consistency. Therefore if we can use a full size implant , then that is our preference. If bone is limited we may utilize a mini implant. If patient finances are a concern we will utilize a mini implant as long as it does not compromise the result or provide the patient with an inferior restoration. Many times, especially in the front of the mouth a mini implant may be the choice for a single tooth gap/problem.
Obviously if the healing caps were initially placed, they do serve a purpose. Without the healing cpas inplace, the implant is exposed to the environment, thereby running the risk of conamination or damage fro food stuffs during chewing.During the healing process the tissue will grow over the exposed implant if a healing cap isd not in place. Many times we place a specific healing cap in order to achieve an ideal tissue contour when the time arrives to take an impression to place a tooth (crwon restoration). If the tissue has grown over the site we most likey will need to use a laser to access the implant for our impressions. This may necessiate a waiting period and delay your receiving a tooth in this area. It is imperative that you contact the Dr that placed the implant and seek their help with this issue.
Based upon your specific situation it may be preferable to extract the tooth that will not be receiving an implant at this time. There are several issues which lead me to this answer. First off, there is obviously the chance that the tooth requiring extraction may flare up at an inopportune time. A toothache or abcess amy occur when you are not prepared financially and or physically to have the procedure performed. I am sure you would prefer to see a Dentist of your choice as opposed to an emergency room Doctor. Secondly, the amount of bone in an implant site is critical to the stability and prognosis of the implant. By prolonging the extraction you are most likely losing bone in the area that the implant is to be placed. This may make the procedure less predictable and the esthetics compromised. Overall the sooner you remove the tooth, the better your chances of avoiding an emergency situation and of providing a good site for Implant placement.
When a bone graft fails there is always a concern. Prior to making judgement however, we must ascertain what exactly failutre constitutes. If the area in question is simply not as built up or properly structured for an implant, a new bone graft is indicated to provide the proper anatomy. If the area is appearing infected, swollen, and showing no sign of bone regeneration further investigation is needed. The first and most common cause of failure is infection. If the site was previously infected, or had a failed root canal tooth or extracted tooth, a round or two of antibiotics is indicate prior to placing a graft material. Once the area heals, I would prefer to place a graft and observe the site before placing the implant. If this procedure does not succeeed, or if an infection was not present we must then assume that the host site is not appropriate for healing and bone regeneration. Many factors can contribute , most commonly the patients health. Patients that have recently undergone chemotherapy or radiation treatment often have poor ability to heal or form bone cells. Other health issues such as diabetes, bone degenerative diseases, and other maladies also provide a poor prognosis for bone graft sites. A thorough health evaluation is a must, especially in cases of failure. External factors can also contribute to the the prognosis of a site. Smoking, alcohol intake, and poor diet are all factors that lessen the chances of a successful procedure
