[Diagnostic / Planning]  IMPLANT vs NATURAL tooth?

Hi Mark,    I hope all is well.  I'll be inquiring with Josh about some of the study clubs that you have in Burnaby in the near future.  I've been placing implants since our course and things are going well (learned to hard way to make sure I have a surgical stent!).  Anyways, the reason I'm contacting you is inregards to a treatment plan that I have.  A patient lost a 37-x-x-34 brigde because the 34 was decayed and was consequently exo'd.  I've planned to do a new 37-x-x-34-33 bridge with the 34 being an implant.  The 34 was exo'd in Nov, 2010 and Mar, 2011 will be 4 mos since exo.     How long should I wait before implant placement? How long before I load it (4 mos?)? Any other tricky thing I need to be aware of given this is the firstvimplant I'm doing that's part of a bridge? Is this even a good idea?   The patient will be getting an ICAT done this month so I can send you a copy as well. Thanks for you time and hope to see ya soon,

by Mark Kwon at Wed, Feb 16, 2011 2:16 AM

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Bernard Jin Replied at Wed, Feb 16, 2011 2:36 AM

Hi 'DA', I definitely agree with Mark that fusing an implant to a tooth (using a fixed prosthesis - like a bridge) is undesirable. Rationale: Generally, teeth have PDL around their roots. The PDL can swell, shrink or become compressed with mastication or parafunction. Implants do not have such force dissipating mechanisms. So, under normal function or parafunction, the PDL of the teeth can compress, leaving the lone implant to bare the full extent of the loads (compressive, cantalever, etc...). The result: overloading of the implant leading to failure. I concur with mark that if possible, place a implant supported bridge 34-x-36. Or 34, 35, 36 individualized impant supported crowns. Bernard Jin

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Mark Kwon Replied at Wed, Feb 16, 2011 2:18 AM

Answer: Good to hear from you.  Glad to hear that you are doing well.  Answers to your question.  1. 4 month after Exo is usually  sufficient time for you to place implant. 2. Marrying implant  and natural teeth are like marrying zebra and a horse. Seems like it should work, but often times leads to failure. In short , I do NOT recommend it.  I would recommend individualizing crowns for #33,37 and  implant crowns for #34,35,36 or Implant supported bridge #34-x-36.  - mark  B.I.T.E.S Institute Learn,Grow,Network...