Advice after a tooth extraction, implant or leave a gap?

[alexfoxy]

Hi,

My girlfriend (33, non smoker) has recently had two molars removed from her upper right set. The two which have been removed are the 1st and the 3rd, counting from the back, leaving the 2nd on its own.

Visually like this: _T_TTTT

The dentist is advising to have an implant tooth where the 3rd tooth was, involving a sinus lift. Visually you can’t see the gap when she smiles but the dentist said there are lots of potential complications when leaving gaps in your teeth, such as:

• movement of teeth
• tooth decay
• super eruption
• sunken face

Considering it is quite an invasive operation she is considering not having the implant, however she is worried about the potential complications. How likely are the side effects happening? Would it be foolish not to get it done? She’s very worried about both options so any advice would be greatly appreciated.

Thanks,
Alex

 

[Dr M]

Good day

Usually when teeth are removed, some movement can take place since the lone standing molar will try and close the gap. This happens over years, and might involve tilting of that lone standing molar.
Tooth decay can be avoided with normal brushing and flossing and regular check-ups.
Super eruption usually only happens if she has a missing lower molar that was opposing the top missing molar.
Sunken face should not be an issue, unless she has several other missing teeth.
If she is worried about the consequences of having a missing tooth, she can always try alternative treatments that are cheaper, such as a partial denture.
Although removable, this can be a good temporary option until she has discussed the benefits of an implant at a later stage, since the denture will act as a space maintainer.

 

[alexfoxy]

Thanks for the response! We will consider the options with this new knowledge.

 

[honestdoc]

I don't think that dentist is very trustworthy trying to sell her the implants. The only for certain outcome is minor tooth movement depending on the remaining opposing teeth as Dr M mentioned.

 

[jedapo]

I got this implant three months after removing the second from back bottom left tooth. I went in one week later to get the stiches out...no problem...two weeks after that I noticed it starting to blister...started on antibiotics right away and today he said it looks much better. I go back in two weeks to see if improved. Doc said the dark area around the top of the implant is where the infection still is but might be improving... can someone in the know tell me what it looks like to them? Hate to go through the procedure again...

Thanks in advance!

 

[alexfoxy]

I don't think that dentist is very trustworthy trying to sell her the implants. The only for certain outcome is minor tooth movement depending on the remaining opposing teeth as Dr M mentioned.

Thanks for the response! I did wonder if the dentist was pushing his agenda. If money was no object, do the risks of having the procedure done (infection etc) outweigh the risks of leaving it?

 

[honestdoc]

I'm very conservative (less drilling, less trauma, less complications). If your GF can function well, then it is prudent to leave it alone. If she has difficulty chewing, then implants can be beneficial. I would go to an experienced implant restorative dentist and that dentist would coordinate with the surgeon on implant placement and other necessary work such as sinus lift, bone grafting, etc. Otherwise like Dr. M mentioned, consider less expensive alternatives like partial dentures. I would stay away from bridges because it needs a lot of drilling on good teeth and once they get drilled, they are ruined forever.

A lot of my patients cannot afford implants and they are doing fine without them.

 

[honestdoc]

I got this implant three months after removing the second from back bottom left tooth. I went in one week later to get the stiches out...no problem...two weeks after that I noticed it starting to blister...started on antibiotics right away and today he said it looks much better. I go back in two weeks to see if improved. Doc said the dark area around the top of the implant is where the infection still is but might be improving... can someone in the know tell me what it looks like to them? Hate to go through the procedure again...

Thanks in advance!

Did you get this implant from an experience surgeon or from your regular dentist? The x-ray shows some darkened bone around the implant possibly indicating poor integration. I would only have implants placed by experienced surgeons because that's all they do and they are very good at it.

 

[jedapo]

Did you get this implant from an experience surgeon or from your regular dentist? The x-ray shows some darkened bone around the implant possibly indicating poor integration. I would only have implants placed by experienced surgeons because that's all they do and they are very good at it.

My regular dentist and i have already paid. I have been using them for a very long time but don't think he is a surgeon. So you think I should get a second opinion??

 

[honestdoc]

My regular dentist and i have already paid. I have been using them for a very long time but don't think he is a surgeon. So you think I should get a second opinion??

I think that would be best.

 

[MattKW]

I got this implant three months after removing the second from back bottom left tooth. I went in one week later to get the stiches out...no problem...two weeks after that I noticed it starting to blister...started on antibiotics right away and today he said it looks much better. I go back in two weeks to see if improved. Doc said the dark area around the top of the implant is where the infection still is but might be improving... can someone in the know tell me what it looks like to them? Hate to go through the procedure again...

Thanks in advance!

That's lost too much bone and the implant surface is certainly contaminated and infected. Unfortunately a lost cause, and antibiotics will do no good. Extract ASAP to minimise further bone loss.