Do I need an implant on #18?

If there is a tooth directly above this space I would replace it with an implant.  It will certainly help maintain your bite over the long haul.  Good luck.  

A dental implant will help you maintain your bite over the years.  It will also help preserve your bone in that area.  I know it is an investment and not covered by most insurance plans.  

Best to have a full complement of teeth to distribute all the biting forces.  Also, having a tooth in this area can prevent drifting of surrounding teeth.

Hello and thank you for your question. The best way to answer this would be with an in-person consultation where they can go over your options. There are several steps in creating dental implants. The Provisional (Temporary Crowns) are critical in finalizing the esthetics and look of the final restorations (Permanent Crowns).  During the Provisional phase the shape, contour arrangement, position and color of the teeth can be tried and assessed to make sure you like the results. Then the temporary crowns can be used as a template for making the permanent crowns this will ensure the subsequent crown matches the color and shape of the surrounding teeth so and once it is placed will fit in naturally with the rest of your teeth. I recommend getting a consultation with a prosthodontist to determine if you’re a candidate. A prosthodontist is a dental specialist who has advanced training in restoring and replacing teeth and can create a customized treatment using the latest techniques in dental implants.

If you have a tooth that would bite against the implant crown on #18, then Yes, an implant would be a great option. The opposing tooth will most likely drift and supra-erupt over time possibly causing issue with it (tooth #15).  An implant would also support your bite behind #19 which has had a lot of dental work and is currently taking a high level of biting force.

If you are healthy and a non smoker, rate of infection is really low. See a qualified surgeon and go for it