Lumineers or Implants Best with Periodontal Disease?

Question

For someone with chronic periodontal disease and bone loss, would it be best to use veneers to improve the look of the teeth or go directly for implants?  Obviously, having the teeth removed is permanent (though so is the progression of periodontal dz) and I can't imagine being ready to run and do that now, but I also think it's important to be practical and realistic.  Veneers would cost tens of thousands, probably about the same as implants?    How long do implants last vs veneers and what is the best option?

Lance Timmerman, DMD, MAGD · Answer

It could be considered "curing periodontal disease" by removing the teeth and placing implants.  If implants are a plan, now or in the future, then adequate bone is needed.  It is possible that the bone level NOW is ok, but won't be there later.
Depending on the situation, veneers on "long teeth" (receded gums and bone) will appear long and unesthetic ("not pretty").  Based on the overall goal, veneers may not be an option and may not last as long due to the periodontal disease.
Without seeing xrays or photos, it is hard to make a suggestion.  I would speak with experienced dentists that have treated cases like yours to see what they suggest.

Herbert Veisman, DDS · Answer

The answer is: it depends at the severity of your disease. If you have advanced or aggressive disease, most likely veneers will not be the best idea as you will be throwing out good money after bad. If your disease is early to moderate and you have been maintained well for a while and are committed to be treated with maintenance for the rest of your life, then you can consider veneers. Implants are an "end stage" option and should only be considered when the discussion turns to "It's now time to extract your teeth before you lose more bone". Ask your dentist or periodontist what stage you are at now and how much bone you have lost vs how much bone you have left. Waiting too long with teeth with periodontal disease can lead to more bone loss and PRECLUDE you from dental implants in the future. Don't burn any bridges with implant and don't sit around too long on periodontal disease  because once you lose a lot of bone, you will need expensive, painful and time consuming bone grafting prior to even considering having dental implants. Food of thought.

Alexandre-Amir Aalam, DDS · Answer

Most importantly, you must be sure that you eradicate all active periodontal disease.  Once all the infection is gone, and disease is arrested (where it doesn't get worse) you will need to have your Board Certified Periodontist evaluate how stable your periodontal status is.  Lumineers can be bulky and may be more difficult for you to perform  proper oral hygiene, which is the opposite of the goals of periodontal disease treatment. 

	Implants are definitely a great option.  However, patients with periodontal disease have higher failure rates and may require bone augmentation prior to implants placement which may increase the length and cost of treatment.  Longevity of both Lumineers and dental implants is directly proportional to patient's compliance and oral hygiene, as well as good overall health.  Bottom line, make sure your disease activity is arrested prior to any option you choose.

H. Ryan Kazemi, DMD · Answer

Veneers are cosmetic restorative procedure while implants are designed to replace missing teeth. Both have distinct indications. And there is periodontal disease which is a condition that requires attention, no matter what treatment option you choose. Here is a common scenario:

	
		Treatment of periodontal disease
	
		Extraction of teeth with advance periodontial disease where prognosis is very poor
	
		Use veneers where indicated providing tooth is stable and has good long term prognosis
	
		Consider implants where teeth are missing or where periodontally involved teeth are planned for extraction.
	
		If both veneers and implants are planned, then the veneers and final crowns are best done at the same time to achieve an aesthetic consistency.

Susan Goode Estep, DMD · Answer

What you may not realize is that through more-recent advanced therapy, your periodontal disease may be controlled, cured, and even possibly reversed!  Make sure you have the best information for treating the periodontal problem first.  It may not be necessary at all for you to lose your teeth, negating the need for implants.  Then you can use porcelain to restore your smile on a healthy foundation.  With this plan, you will give yourself the smile of your dreams that is healthy and will last.

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