• Home
• Advice
• New! FREE Webinars
• Products
• Courses
• Online CE
• Videos

>>Advertise

Dental Implant After Extraction

posted in Treatment Planning & Complications

« Are drugs for bones a threat to jaws? | Dental Implants in the Upper Jaw »

Print This Post

Ann, a patient, asks us:
I recently had tooth 31 extracted after it cracked. My periodontist suggests a dental implant and says that I’ll have problems with the tooth above if I don’t. I don’t want one: It is expensive, and seems like a big ordeal.

I know that
there are possible problems.  My dentist thinks that a dental implant isn’t
necessary and is risky.  He says if it were him, he wouldn’t have it and
would manage quite well without the tooth.  (He’s also the one with no
financial interest.)   So, what would I be risking if I were to forego a dental
implant?  What future consequences might I face and how surmountable
might they be?

27 Responses to “ Dental Implant After Extraction ”

• Dr. Michael Weinberg June 27th, 2006

  
  

  Ann,

  With all due repect, your dentist is ignorant and misinformed. It is this lack of knowledge of dental implants by most GP dentists that plagues dentistry today.
  I myself had that same tooth replaced with an implant and I wouldn’t have considered not doing it. The loss of 31 will cause the opposing tooth to over erupt and render it useless. You will then end up having it extracted as well. Ask your dentist if he restores dental implants. He probably does not. Trust your periodontist and ask him to refer you to another dentist with a more positive view of dental implants.

• Anonymous June 27th, 2006

  
  

  Many factors needed to be considered.

  Advantages of having an implant in #31:

  1. Keeps the bone around.
  2. Prevents surpraeruption of upper tooth/teeth in contact with #31.
  3. More biting power.
  4. More stable bite if other teeth were not in good periodontal bone support.
  5. If tooth #32 is in function, having implant in #31 prevents mesial tipping of #32.

  Disadvantages:
  1. Cost
  2. Surgery
  3. Multiple dental visits
  4. Potential complications associated with implant surgery and prosthesis

• DR. Zev Kaufman June 27th, 2006

  
  

  Dear Ann:
  I am also truly surprised by your dentist!!! The loss of #31, aside of the other factors named above, will also mean loss of support to your temporomandibular joint on that side. However, I completely disagree with the second comments. I am a Prosthodontist who also is certified in implant surgery. I place and restore several hundreds of implants a year and the only disadvantage to implants is COST. The surgical procedure for a simple single implant, done by experienced hands, is a half an hour to an hour procedure start to finish, and is just about as traumatic as getting a large filling. The complications of implants are also usually minor. The restorative phase is also usually a fast two visit procedure that required no anesthesia, or drilling. A single tooth replacement like yours can actually take only two visits, since I can actually take an impression for your final crown at time of impalnt surgery. In short, implant dentistry has changed my life and the lives of my referring doctors and their patients. Go and find a qualified prosthodontist (which I’m sure your Periodontist can recommend to you) and don’t hesistate to proceed with treament that has proven to be the most successful tooth replacement modality in the history of modern dentistry.
  By the way, have your general dentist call me, I’ll get him up to date.

• Anonymous June 28th, 2006

  
  

  Your dentist is an ignorant! Just this.

• Dr. Joel Moskowitz June 28th, 2006

  
  

  Ann,

  Your periodontist knows what he’s talking about. Get the tooth replaced, you won’t be sorry. Your periodontist probably also places implants. Have the restoration placed by either an experienced G.P. or a prosthodontist (either one should achieve an excellent result as long as the implant is placed in the right position which should be choreographed by the restorative dentist). The dangers of waiting too long are post extraction bone and tissue shrinkage which might then necessitate a bone graft in addition to the implant placement. I do agree, that the cost is the ONLY disadvantage.

• Alejandro Berg DDs PhD June 28th, 2006

  
  

  Dear Ann:
  Sometimes is painful to see cases like yours. Your only real problem,is your dentist, so put him aside allong with all your fears and go for an implant. Risk is minimal and as many of my patients say “Implants are my best friends”, it will probably be yours too.
  Good luck

• Marc July 11th, 2006

  
  

  I must object. First, maligning a dentist as ‘ignorant’ is, well, ignorant. No where do I see information on what opposes #31; full denture? does #2 even exist? is it abutement for bridge (so no danger of drifting)? is patient 15 years old or 95? Is patient heavy smoker, diabetic, immuno-compromised? Way too little info is known.

  Also, many people live to ripe old age, healthy and happy without 1, 2 or any 2nd molars.

  Beware, the most ignorant people here are those speaking without sufficent data.

• Anonymous July 12th, 2006

  
  

  Dear Ann: In January/06 I had a an implant procedure to replace a lost molar in the back of my left jaw. The biggest mistake of my life. I am in excellent health and was considered a prime candidate to have this surgery. My periodontist was very qualified and highly recommended. He has been doing implant surgery for 20 years. During surgery, some nerves were disturbed (I felt this during surgery). I have since had nerve sensations, pain and a metallic taste in my mouth. This procedure has greatly impacted my life in a negative way and I would not recommend it.

• Albert Hall July 13th, 2006

  
  

  Ann ,if you are really a patient, do not beleive in your doctor.If you are a dentist asking like a patient, beleive in all comments posted

• TW July 15th, 2006

  
  

  For any of the dentists here to insist that cost is the only con, I disagree.

  The degree of relevance for the factors mentioned in comment #2 may be different among patients, but not to bring it up to a patient who is considering a treatment option is not exactly informing the patient of the pos and cons.

  Since dentists on this post don’t know Ann’s exact clinical picture, how can anyone say that her dentist is ignorant? What if the opposing tooth/teeth has/have poor long term prognosis and her dentist believe that Ann’s remaining dentition provides enough masticating power and TMJ support?

  Comparing to the option of not restoring tooth #31 with an implant, placing an implant has the disadvantage of cost, surgery, time, and complications.

  How can any dentist be so definitive on a forum like this to give a definitive opinion without all the facts?

• Anonymous July 26th, 2006

  
  

  Dear Ann: Don’t do it. There is a reason why most insurance companies don’t cover this procedure - many failures. Also, there could
  be permanent nerve damage and problems can erupt even years after placement. I have been in pain for l year and have been with no resolve. The implant was placed at an angle which hit the next door tooth which is perfectly fine. Now if I remove these implants my good tooth will be lost the second implant next to the failed one and my entire jaw may be break. Also, these surgeons, dentists, Perios and so on never tell you the risk that once you put it in, it is almost impossible to get someone willing to take it out. Good luck. Nerve pain is awful - it’s like a 24/7 toothache and we all know how horrendous that is. Good luck. I wish someone would have educated me prior to my implant nightmare! Jack Lanson.

• chris April 2nd, 2008

  
  

  just had two implants, this is one week later, I feel great and lookig forward to the final attachment in August. There are payment plans and nothing looks bad than a bad mouth. This is your first line of contact with the public, a smile brings warm welcomes. You also will eat and sleep better knowing you did the right thing. Get a Good Specailist and live life.

• Jenny Pearson August 19th, 2008

  
  

  I have two friends with upper molar implants, the first a very healthy lady in her fifties has has major heart problems since the implant, the second a healthy placid gentleman in his 50ies has become very hipper and eritabile. I can’t help but believe these conditions in both are due to the implants.

• R. Hughes August 20th, 2008

  
  

  Dear ANN, You may want another opinion. Dear Jenny, Sounds like B.S. to me.

• Mike September 12th, 2008

  
  

  There are so many different opinions on this subject on so many different blogs/websites my head is spinning and my stomach is turning.

  My situation…my dentist wants to extract my second upper left molar, period. No mention of an implant (which I could not afford anyway). He claims it should not result in tooth shifting or affect my bite. Is this true or not? If it is not true I would rather just leave it there in it’s rotted/cracked condition until I can save up the money for an implant.

  If someone with knowledge of this subject could provide a response I would greatly appreciate it. Also, If I do have the tooth extracted now and can save the money for an implant to replace it 2 - 3 years down the road, would that even be possible.

  There seems to be a lot of hostility on this thread but, even so, I am looking for opinions anywhere I can get them.

  Again, can anyone provide a knowledgable, level headed response.

  Thank you.

• PAUL BETTS September 13th, 2008

  
  

  GREETINGS MIKE

  I AM A MAXILLO-FACIAL AND ORAL SURGEON WHO PERFORMS HUNDREDS OF IMPLANT PROCEDURES A YEAR FOR WELL OVER A DECADE. I PRACTICE IN AFRICA AND THUS HAVE ZERO MATERIAL INTEREST IN YOUR CASE.

  IT IS VERY UNLIKELY THAT LOSS OF THE SECOND UPPER MOLAR WILL MAKE A MAJOR DIFFERENCE TO YOUR BITE (ASSUMING THE REST YOUR DENTITION IS OKAY).YOU MAY EVENTUALLY FIND THE LOWER SECOND MOLAR OVER-ERUPTS UPWARDS AND THIS MAY BE LOST IN THE FUTURE. I SEE MANY CASES THAT CANNOT AFFORD AN IMPLANT. NO-ONE EVER BECAME MALNOURISHED FROM LOSS OF AN UPPER SECOND MOLAR.

  I DO HOWEVER KNOW THAT A CRACKED TOOTH OR A DECAYED NON IDEALLY ROOT TREATED ROOT IS LIKELY TO LEAD TO AN ABSCESS OR EVEN A CYSTIC PATHOLOGY UNLESS REMOVED.

  THE BONE QUALITY IN THE POSTERIOR UPPER JAW IS USUALLY POOR AND FOLLOWING TOOTH LOSS THERE WILL SOON BE LOSS OF AVAILABLE BONE IN WHICH TO PLACE AN IMPLANT. TO ADD INSULT THE MAXILLARY SINUS IS USUALLY VERY CLOSE TO THE TOOTH ROOTS AND FOLL TOOTH LOSS MAY ENCROACH INTO THE EXTRACTION SOCKET. IF POSSIBLE I TRY TO PLACE AN IMPLANT AT THE TIME OF EXTRACTION AS THIS WILL PRESERVE BONE QUANTITY. FAILURE TO DO SO LEADS TO BONE LOSS ELUDED TO ABOVE . SO IF YOU WAIT YOU MAY JUST BE SETTING YOURSELF UP FOR A SINUS-LIFT BONE GRAFT AS WELL. OBVIOUSLY THIS IMPLIES A MORE COMPLICATED AND MORE EXPENSIVE PROCEDURE.

  SO IN MY MOUTH I WOULD GET A GOOD OPINION FROM AN EXPERIENCED OPERATOR AND DEFINATELY REMOVE THE TOOTH(PRESUMED TO BE NON-RESTOREABLE).. IF THE IMMEDIATE IMPLANT IS NOT POSSIBLE I WOULD HAPPILY ACCEPT THE TOOTH LOSS AND HOPE TO SHED A FEW KILOS (WISH IT WAS THAT EASY).

  HOPE THAT HELPS SOME AND GOOD LUCK.

  PAUL

• PAUL BETTS September 13th, 2008

  
  

  OOPS!!!!!

  I MEANT THAT LOSS OF UPPER SECOND MOLAR IS NOT LIKELY TO MAKE A MAJOR DIFFERENCE TO YOUR BITE.

  SORRY FOR TYPE ERROR

  PAUL

• Mike September 14th, 2008

  
  

  Paul,

  Thank you for your response. I am feeling more comfortable with the idea of an extraction now. The thought just took me by surprise initially.

  One thing, I suppose I am cursed with poor dental health but blessed with a high metabolism. I don’t have any pounds (kilos) to shed, so I guess that’s one thing I should be happy about.

• Dr Jeevan Aiyappa September 19th, 2008

  
  

  Dear Mike,
  I am an Oral & Maxillofacial surgeon in India, in exclusive Implant practice in the last 8 years. I endorse all that Paul has advised in lieu of the inevitable malady that you seem to be heading towards (extraction of your upper molar tooth). While it is true that bone loss occurring following the extraction of the tooth can leave behind an area which is depleted of bone and may make any future attempts to have an Implant rehabilitation rather less predictable in its outcome, it is also true that a simple procedure known as “Socket preservation”, (which aims at preserving bone in the region of the extraction and make it less amenable to loss in the consequent months following an extraction , than a conventional post-extraction socket / area would show) can and ought to be employed with bone preservation in mind.
  Several clinicians around the world , affirm the usefulness and benefits of this simple addition to a conventional extraction procedure.
  In the long run , you may even choose to have an Implant placed in the region (at an appropriate time, usually decided by the post-extraction void, the material used for the grafting as well as the rate at which healing has progressed in your case!)

• Beth September 24th, 2008

  
  

  I would NOT do it. I have a friend who had implants done by the best doctor in town. They hit a nerve and she is in constant pain. No way to stop the pain unless they cut the nerve. But then her face will droop.

• Paul February 11th, 2009

  
  

  70% of function is 1st molar forward. I’ve placed lower 2nd molar implants but only when there is abundant bone and the inferior alveolar nerve is a mile away. Dr. Misch does not recommend lower 2nd molar replacements for the inexperienced for 2 reasons; likelihood of lingual perforation (more undercuts in this area) and likelihood of IA damage (the nerve is often higher than the mental foramen); combine the risk of these 2 possible complications with the benefit (70% of function is 1st molar forward) and there will be few patients who meet the criteria for lower 2nd molar implants. The vast majority will not “feel” the need for replacement of a 2nd molar. I’d recommend extracting the tooth and waiting to see if you feel the need for more function. I doubt you will.

  On the other hand, I almost always advise replacing teeth 1st molar forward.

• Paula April 29th, 2009

  
  

  I just had my #13 tooth removed and I am considering either an implant or a permanent bridge. (The teeth on the each side of #13 are totally heathly) So far, I am leaning toward an implant, but some of these comments about nerve damage have me very worried. Is the risk of nerve damage more or less likely at the #13 location ?
  By the way I am 47, healthy, a non-smoker and have no other dental problems.

• Amar Katranji April 29th, 2009

  
  

  Paula, rest assured you are very very unlikely to have nerve damage with an implant at #13. The areas you would seriously consider nerve damage is in the lower jaw towards the back. Talk to your doctor about the specific risks you may have for an implant at tooth #13. Typically, there is little to worry about aside from maybe the sinus cavity…but this is an easy workaround for most implant dentists. Either way, talk to your dentist and ask questions.

• Richard Hughes DDS, FAAID, FAAIP, Dipl.ABOI/ID April 30th, 2009

  
  

  Dear Paula, The area of tooth # 13 is for the most part, a safe area for dental implant treatment. You may need a bone graft prior to treatment.

• Paula May 1st, 2009

  
  

  Thanks for the feedback - I feel better. By the way, I did get a bone graft when the tooth was removed.

• Jamie Shenkman June 29th, 2009

  
  

  I had my second upper molar from the back extracted due to a failed crown which resulted in an abscess and some bone loss. The tooth was extracted and a bone graft completed. Now it’s time to have a CT scan to determine whether the sinus duct has to be lifted. I’m wondering since I’m not too uncomfortable with the space whether I need to have a tooth implanted there at all. I have good teeth on either side of the space. Is there any downside to the gum or neighboring teeth in not replacing the tooth?

• Phil October 22nd, 2009

  
  

  Hi. I was just wondering what is the likelihood of having an uncomplicated dental implant placed in lower jaw albeit 2/3 years after extraction of previous tooth?

---

Leave a Comment

Comment Guidelines: This is a forum for dentists for intelligent discussion. No insults. No outside links. No promotional comments. Though we require an email to route questionable comments to our editors, we will NEVER publish your email. Consumers & Patients: Please do NOT post dental questions here. Instead Visit ChooseDentalImplants.com to get Expert Advice for Implants.

Name (required)

Email (Required, Will NEVER be published)

Website

Message:

Note: At times your comment may not appear on the website immediately, because it has been sent to our editors for approval. Once approved, we will publish the comment. There is NO need to resubmit your comment, if it does not appear on the website immediately.