Dr Klonsky -  Periodontist, Implant Specialist & Coach
Dr Klonsky - Periodontist, Implant Specialist & Coach
Share insight and experience as Advanced Implant Specialist & Coach and Clinical Associate Professor at New York University College of Dentistry
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When To Save A Tooth? Part 2: To Save or Not to Save

When To Save A Tooth? Part 2: To Save or Not to Save

5/16/2019 12:08:15 PM   |   Comments: 0   |   Views: 10

In today’s article, we continue to discuss the pros and cons of saving a tooth versus replacing it with an implant-supported crown.

Deep decay or fracture of natural teeth generally requires root canal therapy. This is an added expense that should be weighed against the cost of the extraction and the implant. If the remaining tooth structure is sound or can be made so, it may be well worth saving the tooth.

When a tooth is extracted, implants cannot always be placed right away. The remaining socket may not be complete or may have been reduced and can require bone grafting to grow new bone in the socket first. If bone grafting is necessary to rebuild the socket, it generally takes about three months for the new bone to be solid enough to accept the implant. Once the implant is placed, it takes three to four months for the bond to take place between the implant and the bone (osseointegration). Today, we sometimes hear about "teeth in a day." I will discuss this in the last of this three-part series.

During the time that the implant is healing, if the tooth that is being replaced is in a visible area, you will most likely need and want to wear a prosthesis to give the illusion that your tooth is still present. Your referring dentist can send the appliance to us before we begin treatment. We can then insert this appliance at the end of the visit when the failing tooth is removed and/or the implant is inserted so that no one will ever know that your tooth is missing. 

The beauty of a crown or bridge that is supported by an implant or implants is that the restoration does not depend on the presence or condition of the surrounding natural teeth. This is a great thing because it avoids the need to grind down adjacent teeth which may be perfectly healthy and attractive, but this would be required if one was preparing to make a conventional, tooth-supported bridge. Conversely, if the adjacent teeth are weak or in poor condition or not present, a conventional bridge may not be an option. Then, the only alternative would be a removable appliance.

All of the above factors should be considered when deciding if it is best to keep and restore the natural tooth or replace it with an implant-supported crown. As you can see, with the right information, a decision can be made which will lead to a healthier mouth and an attractive smile.

In the next and last part of this series, I will discuss immediate placement of implants and "teeth in a day."

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