FREQUENTLY ASKED QUESTIONS
These are actual e-mail questions with the actual responses. We make every effort to answer your questions. Make sure that any e-mails have the word dental implant or dental question in the subject area. Because of the problems of junk e-mail, I routinely delete anything without the proper subject. Your questions can be sent to brooksby1@aol.com.
QUESTION:
I have tooth #3,4,&5 missing due to periodontal disease. My dentist says implants are not successful in the upper jaw because the bone is spongy type vs a harder bone on the lower jaw. I've read your web site and others and they do not say implants can't be used on the upper teeth. I wanted to create a bridge by using an implant in space #4,a pontic in space #5 and a crown on tooth#6. I would use a removable bridge or denture on tooth number 3 since I also have tooth no 14 and 15 missing on the other side. I don't want to spend the money for the back teeth. Thanks for any help you can give me.
ANSWER:
Implants work great in the upper arch. If the sinus is in the way it can be moved, but if you have enough bone now, there is no reason to go ahead. I strongly recommend connecting an implant supported bridge to natural teeth. The end result is almost always damage to your natural tooth. Your dentist is right about the spongier bone. This is compensated by placing three implants, one for each tooth. It may be more expensive now, but considering that the implants do not get cavities, are easy to clean and maintain and the success rate in non-smokers is in the 90% range over 35 years, it is the best investment you could make. The lessor expensive option is to place the partial, but again I would recommend a prosthodontist because of the advanced training in force distribution.
A general dentist can make a partial or do the implants, but usually, although not always, the prosthodontist has skills and knowledge that make it worth the extra expense.
Beware of bargains in brain surgery, plastic surgery and your teeth.
QUESTION:
Can the implant cylinders be rejected.
I'm considering an implant in a location that previously had a root canal, that was finally rejected by the body after 3 years, ( the root was black and the area infected) when removed. I'm trying to determine if the bone in this area could be compromised, it is a year since the molar was extracted. This was my anchor molar. I have also lost the back molar beside it, and would also consider this for an implant. This molar was removed as a result of months of pain, ultimately there was nothing found to be wrong with the tooth except that I had a chronic blister on the side of the gum beside the tooth, that healed when the tooth was finally extracted. As a result of the unsettled behavior of that side of my mouth I'm very reluctant to put something in an area that has so many problems over the last five years.
ANSWER:
Now that the infection has been gone for sometime, it is safe to consider placing implants. Since you are missing two molars, and since they produce the greatest biting forces and have two roots each, I strongly recommend three implants to replace the two molars. The success rate is high and the probability of failure because of the previous problems is low.
QUESTION:
Thank you for the opportunity to email and ask you questions concerning the over denture procedure.. I am very interested in having this done as i have several teeth missing and several teeth remaining...some which are root canals/crowns and some decayed. My question is in regard to how long does this particular procedure take, results, and cost.. I am almost in a dire coarse of having something done soon..and at my wits end, as i have no knowledge of needing a specialist etc.. I also have medical and dental insurance if that is of any help..as my financial status is not great.. Please advise, your email consultation would be of great value to me.. I am located in Phoenix, Az of fair health but have been taking pain meds for the last 7 years due to chronic pain, if there is any direction in which you could assist me I would be very appreciative.. Thank You ...
ANSWER:
The overdenture is a great alternative to conventional dentures. Since you have already had several root canals done, that reduces the cost. Normally root canals run about $500 for front teeth. The dentures are about $3500 and that includes a temporary healing denture so that you do not have to go without teeth The first denture can be done in about a week. The rest takes about two months. The snaps eliminate a lot of movement and the preservation of the teeth also preserves the bone. I understand that money may be a factor. I that is the case we can arrange to do the process in stages to spread out the cost. Be careful of the very cheap for that is what you will get.
QUESTION:
Thanks for your previous reply. Sorry for not getting back to you sooner. In reply to your question about which teeth are missing, all teeth are missing on my upper jaw except for the front 4 teeth. One implant will be placed on the right and two on the left in close proximity to the 4 front teeth due to bone loss in other areas of the gum. Could you please provide me with more specific estimates with this new information?
I really appreciate the time you are taking to be of help to me.
ANSWER:
The treatment plan sound appropriate, if you do not mind using the partial. If you want to eliminate the partial, you may consider having the sinuses moved up and bone grafted on both sides. They could then place 3-4 implants on each side with implant supported bridges that are not removed. This is like having your own teeth again.
The fees for the Implants with "o" ring snaps is between $1800-2500 for the surgery and $1000 for the snaps. Usually in our office the total is between $3000-3200.
The implant crowns are about $1500 each. The sinus lift and bone graft would be $1800 per side. You can do the math.
QUESTION:
I‘m interested in dentist service – implantation. I'm from Russia, Vladivostok. Russia only begins to use that service and the technology of the implantation is far from perfect that's why I need your service. I‘d like to get the following information:
? Specialities of implantation technology;
? Period from put an implant till covering it with a crown
? Which of the metal an implant made of
? Price and discounts if make several implants
? Contra-indications for that operation (age, diseases)
I'm looking forward for your answer. Please reply to me as soon as
possible. Thank you for the time.
ANSWER:
In the USA implants are generally placed by oral surgeons, periodontists, prosthodontists and general dentists. The procedures are not difficult and can be relatively pain free. The time from placement of the implant until the crown or attachment is placed is generally 4 to 6 months. The implants are made of titanium and are extremely biocompatible. The cost ranges from $3000-4000 US$ including the surgery, the follow up care and the crown or attachment.
Smoking is a major contra-indication. It substantially reduced the success of the procedures. Chemotherapy is also a contraindication and the patient must have been off of the chemotherapy at least one year before implants can be placed. Most other problems can be addressed if controlled.
QUESTION:
Your web site is most informative. Thank you.
My mother lives in Greeley, Colorado, and wonders if you might recommend a Prosthodontist, Oral Surgeon, Periodontist, or General Dentist for her in the Greeley or Denver area.
ANSWER:
You may try the website of the American College of Prosthodontists.
They have links to prosthodontists throughout the nation.
QUESTION:
Dr. Brooksby, I am impressed with your website on dental implants and other alternatives. Your articles are laid out well and are easy to read and are very informative. More importantly, the pictures of patients bearing the results of your work are very impressive. It is very plain to see that you enjoy helping with their appearance and are a proud professional. I am a 43 year old male that is a candidate for dental implants or some other alternative means of tooth replacement. I have 3 missing teeth on top that are near the front and highly visible. I also have multiple teeth missing on both sides on bottom. I live in Alabama so it will be necessary for me to locate a dentist in my area to do this work for me. Do you know of someone in my area that you would refer me to? Your response would be appreciated.
ANSWER:
You can look up members of the American College of Prosthodontists. Not all Prosthodontists are surgical prosthodontists, so you will have to ask. The biggest difference is that a surgical prosthodontist does the implant placement and restoration while the regular prosthodontist has a surgeon do the surgery and he does the restoration.
I hope this helps.
Ever consider a couple of vacations to Las Vegas?
QUESTION:
I would tremendously appreciate if you were kind enough to answer my questions concerning my wife's treatment.
For a variety of reasons, she has been left just with two lower anterior teeth of her own (#22 and # 27) which were treated endodontically. Recently, her dentist proposed to place a fixed bridge on these two teeth. Common sense tells me that this is not the best option. In the long run, will those two teeth be able to support 4 false teeth? There is even some bone loss. I know that it may be difficult to offer any advice without clinical examination, but I hope that you could give us very useful suggestions , at least, in general terms.
Thank you very much for your kindness in advance.
ANSWER:
As you look at my website you will find a section on over dentures. If the two teeth are cut off just above the gumline, a denture can be made right over the top of the teeth. They still provide support so she can chew better, but snaps can be added to the teeth to help hold things in.
If one of the teeth is lost the denture still functions and an implant can be added without having to replace the denture. I recommend a metal bar in the denture for strength.
QUESTION:
I found the information on your web site extremely useful and informative, and was hoping that you could answer some questions I had. I currently have removable prostheses (partials) on my upper jaw that do not hold firm while chewing. My dentist has suggested 3 ENDOSTEAL ROOTFORM implants as a remedy (to be performed by an oral surgeon). Following this work, my dentist will undertake the placement of 3 BALL-TYPE ABUTMENTS to support new removable partials that will map on to the abutments. Before I finally decide on this work, I would appreciate receiving information on the following:
1.) The approximate charge for the 3 ENDOSTEAL ROOTFORM implants.
2.) Is the work on the placement of the abutments proper to the oral surgeon or dentist?
3.) The approximate charge for the 3 BALL-TYPE ABUTMENTS?
Any ballpark costs that you can provide will help me make a final decision.
ANSWER:
It would help to know which teeth are missing. Since I don't know, I will answer with generalities.
1- I love implant supported 'O' ring attachments. Made properly they work well and can really make a difference. Usually you will find that your existing partial can be used.
2- You will notice that I am biased. I think a surgical prosthodontist is the best choice because he not only places the implants, but restores them. This give him more control and you only have one person to deal with.
3- The cost in my office is between $950-3000 each for the implant placement, the followup care and the snaps added to the partial.
I hope that this helps.
QUESTION:
Dr.Brooksby, I am Egyptian dentist , what kind of crestal incision you are always used for placement of implant and why. some surgeons put the incision line buccal to the crest others put it lingual and others put it on the crest. Thanks for help
ANSWER:
I personally use a mid crestal incision for most of my surgeries. This keeps the margins of the tissue as firmer attached gingiva. If the ridge is definitely wide enough, I do not do an incision, I just penetrate straight through the tissue. My final drill is one size large than the implant and just penetrates the tissues, but not the bone.
QUESTION:
My #8 tooth was injured and broke above the gum line. My gums are in excellent condition and my surrounding teeth are fine too, but I have scleroderma which has made my gums exposed when I smile.
I got a dental implant. Medically it went well, but cosmetically it is awful; it was set too high and the new "tooth" will be at least 2mm higher than my gum line. Since it's my most visible tooth, I've been told that I can have the implant removed and go for a resin bridge, but once I decide there's no going back.
My illness makes me extremely self-conscious about my appearance, and I get very depressed about my tooth, but I understand that there can be horrible results with bridges. I do like my prosthodontist, and I don't have anything more to do with the surgeon who put the implant in.
I would like to know how I can get more information so I can make a reasonable decision between "form" and "function." Thanks.
ANSWER:
On of the problems with dental implants is that sometimes the results at the gum line can be less than ideal. There are cosmetic surgeries that a periodontist could perform that may help solve your problem. Personally, unless it is so bad that people repeatedly comment about it without being prompted, I would stick with the implant. A resin bridge would affect what I would assume are perfectly healthy teeth.
If you want to come to Vegas, I would be glad to give you my opinion. You may even be able to write off the trip.
QUESTION:
My Mother who is 78 is a diabetic and has lost most of her teeth. Is it true because of her Diabetes she can not have implants? If dentures are her only option do you know of a good prosthodontist in the Ft Lauderdale area? Thanks.
ANSWER:
It is not true that your mother cannot have implants because she is diabetic. If she is controlled she is just like anyone else. If she is out of control, she is at a much higher risk of infection which could affect the implants or even her life. I know several prosthodontists in Florida, but the info is best obtained from the American College of Prosthodontists.
Question:
My wife had three of her teeth knocked out in an auto accident 18 years ago. The original fix was to grind down another tooth and glue a permanent bridge to the ground down tooth and to another tooth. Ultimately, the bridge lasted 16 years. Two years ago, my wife had the permanent bridge removed. This was replaced with a temporary floating bridge because she had braces installed two years ago. She has had a few bottom front teeth removed (for space) and now is close to be completed with the straightening process. We will soon have to decide on what type of replacement teeth. She now has a four tooth gap to replace (all top teeth including one of her front teeth). We have been given two options: (1) Install two implants, one at either end of the gap. Then, attach a permanent bridge of two teeth between the two implants screwed on to the implants. (2) Install a permanent bridge of four teeth to the existing teeth.
What do you recommend and why? We want what will last the longest and look the best, not what is cheapest...My wife is 40 years old in good health. Her dental health is also good and her teeth are now straight. There's just a big gap where four teeth used to be. The dentist and orthodontist say she appears to have a lot of bone material to support implants..Any ideas? .
ANSWER:
The answer to your question depends on the adjacent teeth. If the teeth are in good condition with great tooth structure left, then a bridge would require cutting them down to support the bridge. If anything ever happens to either of those two teeth, the entire bridge would be affected.
If you don't mind waiting for the healing process, and it appears that you already have patience if you are completing braces, then the implants will preserve the jaw bone and allow restoration of the teeth without touching the adjacent teeth. Also most of the time, if the bridge ever breaks, it can often be removed from the implants, repaired and put right back where it came from.
QUESTION:
Is is possible to graft bone in an area of the mouth that does not have enough bone to support an implant? If so, is it more successful to graft real bone or a substitute? Can bone be grafted to areas around teeth for cosmetic purposes only?
How successful are dental bone grafts?
ANSWER:
It is possible to graft bone. I prefer to use real bone. The synthetic stuff has never worked really well. That is unless you consider spitting synthetic bone out every once in a while. Grafting for cosmetic purposes is usually done by a periodontist.
QUESTION:
Please send an information about implant source of DIGITALX-RAY, COSMETIC TOOTH WHITENING. I WOULD BE HIGHLY THANKFUL TO YOU TO SEND AN INFORMATION AT MY MAIL ADDRESS.
ANSWER:
Click here: Digital x-rays
Click here: Schick Technologies Home Page
Click here: Tooth Whitening
QUESTION:
I am a Head & Neck Surgeon from Cordoba, Argentina.
I would like to know which is the best treatment for the resorption of the alveolar ridge. Thank you very much.
ANSWER:
The alveolar ridge's main function is to support the teeth. When the teeth are removed, the ridge begins to resorb. This happens whether the person is wearing a denture or not. A dental implant is able to preserve the ridge because it functions within the bone just as the tooth does. If the bone has already resorbed and you want to grow new bone that is more complex and it depends on whether it is the maxilla or the mandible.
Espero que esto lhe ajude.
QUESTION:
I SHALL BE OBLIGED IF YOU COULD CONFIRM PER RETURN E-MAIL, WHETHER DENTAL IMPLANTS ARE SUITABLE/ADVISABLE FOR PATIENTS WITH EPILEPTIC PROBLEMS. ARE THERE ANY DRAWBACKS IN SUCH CASES.
ANSWER:
I see no reason why a person with Epilepsy can not have dental implants. Some may wonder if it would cause injury to the patient during and attack, but it seems to me that it would be just like having your own teeth.
QUESTION:
2 1/2 yrs ago I was in a motor vehicle accident, which caused me to lose my 2 lower incisors. I also lost significant bone, and after 1 year of orthodontic treatment, I pursued an oral surgeon about implant feasibility. He was reluctant because of lack of space, even though the xray showed that my roots were straight and healthy.
Thirdly, I consulted a periodontist, he said my teeth were healthy and strong and that I should see a prosthodontist about bone replacement, and possibly the option of having only one implant, and a crown because of the lack of space in the bottom right side of my jaw.
What are your thoughts about my situation, and can you give me an accurate cost. How different is cost comparing Canadian and USA figures?
ANSWER:
If the space between the front teeth is to small for two implants, one implant with either one or two crowns can be placed. The cost per implant surgery would be about $1800-2500 US. The crowns would be about $1200-1800 Each. I estimate usually about $3600 per tooth
QUESTION:
Hello. I am interested in finding out about any research done on insulin-dependent diabetics that have had dental implants done. I am in the process of deciding whether to do a fixed bridge or implants and would appreciate any information you can direct me towards.
ANSWER:
There have been studies done in the by the VA Medical Centers on the placement of dental implants in Insulin dependent diabetics. That research is on going and the program where I trained is involved in that study. It seems that if the diabetic is well controlled, that he heals normally. If he is not well controlled then the problem becomes recurring infections that can result in loss of the implants.
QUESTION:
About 3-4 years ago I had an implant done on my lower left 2nd to the last tooth. (please forgive my terminology I sell computer software and know little about the dentistry lingo!!) The implant stood firm for about......3 months! I have gone in several times to have my "screw tightened" and still have a "loose screw" within a day of tightening. Do you know of anything that can be done. The last time my dentist tightened my implant it lasted for about 5 hours. He said since my implant was done the materials have changed and that there is nothing he can do?? Now, once in a while, my jaw gets sore around the implant. I'm 26 years old and I'm starting to get nervous about my jaw/teeth. On my x-rays it almost looked like my jaw was withering away around the implant could this be true? My hygienist noticed it too but my dentist say its nothing to worry about. If you can give me any advice or comments I would greatly appreciate it!!!!
ANSWER:
I am sorry you are having problems. It would be helpful to know what kind of implant was placed. Was it a blade, subperiosteal, IMZ, Corevent, Branemark or another kind. Is it connected to your natural teeth too? Is there just one and what size implant was used?
It is possible for bone loss around an implant. This is often because the implant was overloaded. Usually I recommend three implants connected together in the back because that is where you get your greatest chewing forces. When God made molars he made each one with two or three roots.
Screw loosening could be because there is too much load on the implant and it could be because the crown didn't fit or because it was attached to a natural tooth and because the tooth attachment to bone is very different than the implant it causes problems.
I hope this information helps. If you would like to vacation in Vegas and have us take a look, let us know.
