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Two dentists, Two opinions (implant)

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Posted by: crosbie  (10 years ago)

Five months ago, my #26 tooth was surgically removed. Two crooked roots did not want to come out, so work was performed on the jaw bone as well. Afterwards, everything healed without any complications.

Now dental prostheses are on the agenda. My dentist, who pulled the tooth, is telling me that an implant without a sinus lift isn’t possible because there is not enough bone material and the maxillary sinus is too close. However, in his opinion, the neighboring teeth, nos. 25 and 27 (both without root canal treatment, # 25 with a deep filling, # 27 with a crown) offer enough bone, so that this space could be considered for an implant, just in case they have to be pulled at some point in the future.

He’s using an X-ray that was made after the tooth extraction five months ago as a reference. Therefore, he recommends a zirconium bridge.

Dentist # 2 took a panoramic X-ray four months after the tooth extraction (the other dentist x-rayed “only” 3-4 teeth) and is of the opinion that a direct implant would be possible. If necessary, the implant would protrude into the maxillary sinus, which would not be a problem. If necessary, he would augment the bone a bit, which I wouldn’t notice. He takes a more critical view of the possibility of a future implant at # 25 or # 27 since, in his opinion, there is a lot less bone material to work with there.

So, what should I get done? Two dentists – two opinions. I trust both doctors. Or could the bone have changed so much in the last four months? But dentist #1 should know that. The financial aspect is not a criterion in my decision; I just want to be trouble free as long as possible.

Thank you very much and kind regards!

PS: Just to report something positive about teeth that have had root canals: I have a large molar on the lower jaw that has not given me any problems in 18 years – no discoloration either. To date, it has had a filling and is now supposed to receive a crown in order to preserve its stability.
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Posted by: crosbie  (10 years ago)

Both dentists implant. I don’t think this is the reason for their different opinions.

I am middle aged (40 y/o) and a non-smoker, no parodontitis, no other medication/illnesses. It is my first pulled tooth.

Could the bone have re-established itself so well within the last five months that the more recent X-ray by the second dentist looks so good?

Do implants last an entire life if well-cared for, or do they have to be replaced at some point in time?

I’m leaning towards a bridge now instead of having something rammed into my jaw that might not last.

Thank you