When should Dental Implants be placed?

Dr. Brooksby- I know that you have talked about this in the past, but I keep hearing ads about immediately placing implants after extraction and that you do not need to wait for healing before placing implants. I have been to your website http://lvimplant.com and noted that you recommend waiting. Why the differences. What is the real answer. Confused.

Dear Confused-

History of immediate implants

In the early 50's and 60's it was not uncommon for dentists to place dental implants and put teeth on them immediately. Many of these worked initially, but after five or ten years they began to get infections and eventually failed. When the type of implants that we most commonly use today were first developed using titanium they found that a delayed healing provided a long lasting bond to the bone. Titanium is a bioactive metal which is able to trick the body into believing it is part of the body if it does not move. If it does move then the body rejects it as a fake. They purposely did not bring their implants to the USA for almost fifteen years because the feelings against implants and their failures were so strong. When they did come to the USA they insisted implants only be done by oral surgeons and prosthodontists. These requirements were gradually relaxed so that now almost anyone that wants to place an implant may do so.

Immediate Implants Today

In today's competitive environment some dentists are beginning to look for ways to entice more people into their offices and to convince patients to let them be their implant doctor. They have forgotten the lessons of history and are beginning to do the same things that were done in earlier years with the presumption that titanium solves all of the old problems. The problem is that many of the manufacturers that used to represent the developers of the current dental implants now are the proponents of these aggressive techniques. With little research to back their ever changing implant designs they are now encouraging these dentists to use their patients as the subjects of their research.

With some experience many doctors soon realize that the manufacturing claims are false, but they love the extra attention to their ads so the ads do not change. Now if you go into these offices many will advertise "teeth in a day" yet tell you after looking at your CT scan that because you have softer bone you will require the more conventional delayed implant procedures. This is known in some circles as "Bait and Switch". One of these advertisers in a lecture with local dentists admitted that he found an unacceptably high failure rate if the implants were placed at the same time the teeth were extracted.

Learning from History

We are here for the long haul and want our patients to be happy the day they get their new teeth as well as twenty years later. For the cost of dental implant supported teeth it is best to be wise and follow the techniques that have the best life expectancies. As with anything done to try and follow in Gods footsteps. If we follow his rules we will be rewarded. There still may be failures and complications, but that is how we learn to deal with adversity. If things do go wrong it is comforting to know that you are being treated by those that have the latest information, but the experience to know how to proceed.

If you are interested in dental implants call Dr. Scott Brooksby at , see http://lvimplant.com. If you have questions you would like answered in this column email Dr. Brooksby at scott@lvimplant.com