Implants immediate placement

As an Orlando dentist I get many calls weekly about implants. You know implants are the best thing going. If you have lost a tooth you can now have it back with a implant. An implant is a titanium cylinder that is placed below the bone and acts like a root form of a tooth. A major issue with these is the waiting time from the extraction date to when you have a implant placed. I have placed literally thousands of implants now and the best way to do it is have the tooth extracted that needs to come out and the extraction site grafted with bone. Now let the site heal for 4 months before placing the implant. This allows the bone to regenerate and good new bone for the implant. This allows you to place the implant with bone on all sides, which in my oppinon is better than immediate placement.
The advantage of immediate placement is you do not have to wait the extra 4 months for healing. When choosing immediate placement there are a few more risks involved. When taking the tooth out you have to have bone on all 4 sides or it is not a good candidate for immediate placement. You should just graft and wait the 4 months. It is also more costly, because you have to add bone in areas that are not yet healed to give the implant a better chance. With immediate you have a risky situation if it does not integrate and you then have to graft and start all over. You might have a medical situation that leaves you to immediate placement, but all in all I graft my sites 90% of the time and go back in 4 months and place my implant. I have the best success doing it this way. Immediate placement you lack stability and are hoping for integration and that the implant will tighten up in 4 months. I will be happy to answer any of your questions if you ever have this choice.

Dogs need there teeth cleaned too!!!

This is an interesting topic today. I receive many phone calls and questions from patients of mine that ask me if there dog should get there teeth cleaned like humans do? Yes they should. Animals like dogs should get there teeth cleaned at least twice a year. Most Veterinarian's do provide this service. By getting the plaque and tarter off the dog's teeth you are doing the exact same in regards to good health as your doing for humans. You are promoting good health with there gums and there heart. The doctor will use a cavitron like humans to remove the tarter and get the teeth clean. Most Vets do this on there regular check up yearly. If you need a referral don't hesitate to call I have a great Vet.

In my practice we are also doing something interesting. Some dogs wear there chewing cuspids out and we are placing implants in dogs in the position of there cuspids so they can eat and chew. These teeth are the dogs most valuable teeth when eating because it tears the food for them. So we are placing implants if they wear these teeth out. Just like humans. We work in conjunction with the Vet at the Vets office where he sleeps the animal to allow us to place the implant.

Thanks again for reading.

Extraction Site Grafting for future implants

Many times like I stated in my last blog, we have to take a tooth out and choose to have a implant placed. This is the best way to go in a lot of cases especially now that implants are so successful. Years ago when we took a tooth out we did not put something back in the hole, we let it heal by secondary intention. Now we see that the ridge has a horse saddle appearance due to lack of bone and the way the area healed after the tooth was extracted. If we do want to place a implant you want to graft the extraction site with more bone as to allow the area to heal all the way to the top. You will have only a minimal dip and this will allow you to have better implant placement. You are placing the implant in a flat surface instead of a saddled looking surface which the later will not allow you to make a cosmetic crown. It will make the new implant better periodontally as well. You will be able to clean around your implant as well. I have been doing this procedure since the early 1990's and with great result. You can use your own bone or a synthetic which your body resorbs and lays down its own to fill the extraction site to the top. The synthetic bone acts like a scaffold for your own bone to follow.
So all in all when doing a extraction where you are going to place a implant in 4 months you will get a better result with your implant in the end by grafting the site with bone.

Implants vs. Endodontics

As an Orlando Dentist many patients call and ask questions about if they should do a root canal or just place an implant. That is a very good question? In years past the answer would have definitely been to do the root canal. I am a firm believer in doing the root canal most of the time since it is the tooth God gave you and no one can make it better than he. Doing the root canal when a tooth dies is because the nerve inside the tooth is affected. All you are removing is the tissue inside the tooth. The tooth is still good. In these cases it is better again to save the tooth. When a tooth becomes more compromised or has some strikes against it, then I start to consider the alternative. Now your prognosis might be guarded in doing a root canal , then I consider putting a implant in. If the tooth needs a surgery or crown lengthening or even a apicoectomy then I consider a implant. The apico is a root canal done surgically where you have to cut the end of the root from the top rather than going through the tooth. This is another circumstance I would consider an implant. These additional procedures that cost money and put the tooth prognosis in a guarded position makes me really think of Implant or Endodontics.
With Implants in this day being so successful I lean to placing these if there is a compromised situation. Implants are very successful and there really is no down side. The success rate is very high. You can take the tooth out and in a lot of cases place the implant at the same time or no later than 4 months later. Implants are a tooth like fixture made out of titanium that is put in as easily as a screw in a wall. You will now have a situation with the implant where there is minimal to no chance of failure and your money going forward. In my practice I always try to lay it out for my patients both ways. I should them the risks and benefits of both implant and root canal. Each situation is unique and different. You have to look at each tooth separately. In the end it is a judgement call by the dentist, but now with implants it is easier because you have a successful alternative and don't have to keep trying to save a tooth that will not make it long term.