Dental Implants for a Single Tooth
Oral Surgeon, Dmitry Y. Tsvetov, DDS, MD, Temecula Facial Oral Surgery
Dental Implants for a Single Missing Tooth
When a single tooth is missing and a dental implant needs to be placed, there are two important questions that need to be answered: First, how long has it been since the tooth was removed? (Typically need to wait at least 3 months for the bone to heal after a tooth extraction before a dental implant can be placed). Second, is there enough bone available to be able to place a dental implant? (Implants need to be surrounded by bone on all sides in order to provide a good functional outcome, so the more bone there is, the better). The amount of available bone can be determined by doing a special type of a dental xray called “Cone beam” or 3D scan. This is a mini-cat scan, but with a lot less radiation
If enough bone is available, implant placement is relatively simple. It can be done with local anesthesia (without being put to sleep) an about 30 minutes. After the implant is placed it needs to heal inside the bone for 3 months before the crown or “cap” can be placed on it
If enough bone is not available either in terms of height and/or width of bone, procedures to “regrow bone” need to be performed prior to implant placement. Please see “bone grafting” section for more information.
Dental Implants for a Single Non-Restorable Tooth
In a situation when a single, non-restorable tooth is present but needs to be removed and then replaced with a dental implant there are two pathways in which this can be accomplished. The first option is an “immediate implant option”, where a tooth is removed and an implant is immediately placed into the jaw bone. The second option is “delayed implant placement”, where the tooth is removed, the extraction site is allowed to heal, and the dental implant is placed three to four months later. So let us look at each of those options in detail and discuss advantages and disadvantages of each.
Immediate implant placement: This option is most commonly used in situations where a tooth with a single root needs to be removed. Since the dental implant closely resembles a root of a tooth in size and shape, it’s a fairly straightforward procedure to remove a tooth and to replace it with an immediate implant. This becomes a lot more challenging and less predictable when multi-rooted teeth or “molar teeth” are involved. Since those teeth have two or three roots it is very challenging to be able to place a single implant, working in between two or three extraction sockets or “holes” left behind by the removed roots. Also, when molar teeth are involved, important anatomical structures such as a nerve in the lower jaw and maxillary sinuses in the upper jaw are involved. The proximity of these structures makes immediate implant placement even more challenging.
With an immediate implant placement a typical timeline is this:
Tooth removed and implant placed → Wait 3 months for healing→ Implant is checked for stability and is ready for restoration (cap). Total treatment time (from extraction to completed restoration) 3-4 months, depending on how long it takes to make the tooth “cap”.
Advantage: Less total treatment time; Disadvantage: Cost—need to pay for the extraction and implant at the same time
Delayed implant placement: This option is most commonly used in situations where a tooth with multiple roots needs to be removed and a dental implant placed. As mentioned above, it is very challenging to do an immediate implant in this case. A more predictable and simpler way to do treatment in this situation involves removing the tooth, letting the site heal for 3-4 months, place a dental implant, let that heal for 3 months, and then the implant can be restored;
With a delayed implant placement a typical timeline is this:
Tooth removed → Wait 3-4 months for healing→ Implant is placed→ Wait 3 months for healing→ Implant is checked for stability and is ready for restoration (cap). Total treatment time (from extraction to completed restoration) 6-7 months, depending on how long it takes to make the tooth “cap”.
Advantage: Cost—pay step by step, not everything at the same time; Disadvantage: Total treatment time is 6-7 months (compare with 3-4 months for immediate implant placement).