Thursday, November 12, 2009

Dental Implants - What does it mean when the Periodontist says that the site looks solid?

I had dental implants and bone grafting done on teeth 7/8 on Wednesday, Jan. 10. Both teeth were pulled at the same time. On March 14, I had them checked, no X-rays done by the Periodontist who did the work. He said it looked solid. What does that mean? How can they know if the implants are going ok just by looking at the site? Also, he said I could schedule my impressions for two weeks from now. Is that too soon for front teeth? I feel as if they are still healing. Will my restorative dentist know if it's too soon for impressions? How long does the front teeth normally take and what about upper back teeth? I also just had a cleaning done on Tuesday and the dental hygeniest cleaned my implants too. I didn't feel pain or discomfort when she did. If these go well, I may want to replace a few in the back too someday. What are the risks on the back top teeth as opposed to the the front top teeth? How soon for back teeth to heal if fronts only needed two months?


THANKS.

Dental Implants - What does it mean when the Periodontist says that the site looks solid?
IT MEANS THERE IS ENOUGH BONE TO PUT AN IMPLANT IN PLACE, THIS IS GOOD NEWS.
Reply:When your periodontist said they looked solid, he meant just the appearance. A radiograph (X-Ray) would have provided more information, but at this point he may be just be looking at whether the bone graft stayed in place or disintegrated. If it had disintegrated, the site would have appeared hollow and then he would definitely have wanted to X-ray the area.


Bone quality in the front teeth area is better than in the back teeth area. Actually bone quality of the posterior maxilla (back teeth area in the upper jaw) is worst of all areas one can get implants in. My guess would be a couple months longer than this time, but it would also depend on the kind of graft and how quickly the graft helps fill in bone.


The sinuses are located above the back teeth and sometimes the sinus membrane can get damaged during a bone grafting procedure, but your periodontist should be a ble to fix it pretty easily and also, such a thing happening is not very common.
Reply:Congrats on your new implants!





Only your periodontist knows for sure what he meant. What he likely meant is that the implants "felt" solid: they didn't move in the bone. This is a huge indicator. If, after 2 months,


the implants are stable, studies show us that restoring implants in the upper front jaw is safe. This is how he "knows." Often the hygienist or periodontist takes films as well.





You "feel" like it's still healing? The implants will continue to be integrated into the bone, but they are unlikely to get "more solid" at this point.





Your restorative dentist might or might not know by looking that the implants are stable. That's why she's working with the person who placed them.





Discuss your interest in additional implants with your restorative dentist, who will likely refer you back to the periodontist for additional evaluation. The bone in the upper back jaw is softer than the front (and on the bottom), so the issues are a little different.





Good luck!
Reply:after extraction, you wanna wait 6 months for the upper, esp for the 'esthetic zone' (front teeth). this makes for better healing and more bone fill in the that area. if you do it too early, your bone is still changing (as you hinted) and could change the restoration look along with it.


i'm sure 'solid' means enough bone to place the implant in that area. solid i don't think is a technical term.


if the perio guy took films or a CT prior. he probably is comparing the bone now to then. he prob should take some more films to be sure. i'd rec'd it. although in that area it's fairly predictable how the bone is shape (unlike the lower back areas; you can get some irregular bone in those areas)


yes impression can be done... but at which step... if it's for the final impression, i'd ask a couple more quiestions... if it's for the inital impression to make another 'customized' tray, it's probably cool.


restorative dentist shoudl know if it's too soon. no doubt. the perio should know too though.


uppers in general take 6 months; but you can take impressions as early as 1 -2 months. reason you want a little longer in the front is for esthetics. so it'll vary, case by case.


cleaning the implants is fine. but NEVER metal on metal. gold and plastics instruments should've been used.


implants are very predictable today. in the posterior upper, you want to be aware of your sinuses... it could come close to where the implant ends.


remember the numbers are all textbook and can change from case to case.


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