Age for Dental Implants: How Do I Determine that Bone Growth Has Ceased?

No way to tell for sure. Orthopedic radiographs of hands are known to be inaccurate according to studies. It really differs from one individual to another. Although 16 for females and 18 for males may be acceptable to some, Misch recommends looking at other factors such as comparing size of patient to parents or asking patient or parent directly if they stopped growing. As u can see it's mostly subjective. To be safe I think 21 for males and 18 for females. Even with that there's no guarantee, there still may be late growth.

As Dr. B mentioned 21 for males and 18 for females is a ballpark. I would not recommend asking family, since even small changes in growth may not be noticed. Take 2 cephalometric radiographs, at least 6 months apart and compare. If your measurements do not change, you should be safe in assuming growth has stopped.

Some good orthognathic studies have proven that facial growth stops sooner than we once thought. Hand/ wrist or growth plate films ,have failed the definitive litmus. Nothing beats a thorough physical and history, with attention to the biologic parents/ grand parents. Also do a retrotime growth spurt history. We have been doing osteotomies on mature 15 and 16 year olds, for the last ten years with no increase In surgical relapse. We are following these patients more closely than our adults, so I have no numbers or any data driven studies to support this opinion. Bv

i think this would be dictated by suture line closures in the skull...particularly the max/mand.i know they may close prior to full growth,but when are they fully calcified. just use a space maintainer until at least 15 or 16

The one study by Ellis et. All , suggested comparing lateral cephlametric x-rays , over time. This is when all the answers applied to gestalt , separate the good decisions from the bad. Put them in space maintenance and wait. If you wait too long ,however, you may find your patient needing an autogenous block graft. Bv

What's the rush? My personal opinion is that it is safer and more predictable to wait until at least 18 years of age, male and female. But again, why rush things? A flipper appliance is annoying, yes, but it is completely passive and certainly doesn't interfere with any definitive work later on. Let them grow up, and maybe they'll appreciate the implant even more.

I agree , dr. T, but try and explain that to pretty 17 year old that avulsed number 8 and is going off to college. Assuming it's not a comminuted alveolus, I'm placing the implant and graft, every time. Even if i know they are gonna have a growth spurt. A block graft to this area two years later, is three times more complicated. This is the premise of retainers in ortho, isn't it? Bv

it is really an issue of debate ,, no two authers agreed to obsolute figure on when growth stop.P.w booth said that you can go for genioplasty when lower canine completly erupted,Bsso when lower 7 erupts .Harris said that it is better to wait for 18 to 20 y of age to go for Bsso. IN ortho books they said that sella nasion landmark and inner lingual contour of mandible are the most predictable for comparing two series of lat cepf to say that growth has matured.Anyway growth is a continues process and never stops

2 Cephs 6 months apart. If no changes, you're good to go.

Good question. I am ignorant here. Does anyone know what happens when an implant is placed in a growing child or are we just assuming that problems will occur. Greg Steiner Steiner Laboratories

Pardon the late entry Greg. Seems like a lot of what we do is based on " lore ". Clinda- c. Dif. infections. Early tx of maxillary infection- causing the cavernous thrombosis . Sucking through straw - causing the "dry socket". Small scatter radiation- cancer. Early removal of the abscessed tooth - causing sepsis. No one places the implant in the young patient, but kids are finishing ortho at age 12, sometimes. My son being one of them. Good retention seems to work. I'll say it again, there are some good studies that prooves facial growth stops sooner than we once thought. The youngest implant I have placed is in a 15 year old , that was 6 feet tall. That was 18 years ago and it looks good. Bv