Implant advice?

[cuspidarrow]

I would very much appreciate some advice from a periodontist or anyone in implant specialization.

My dentist (general) have been in practice for about six years and have recently completed implant training by attending a seminar once a week for about 6 months. He's treated two patients so far with implants recently and I am considering getting one implant (tooth #19) done by him. (He won't charge me)

I've worked with him as an assistant for a year so I trust him. However, I can't help thinking that I should go to a specialist for proper treatment. Any advice?

I will be attending dental school in the fall. How easy would it be for me to get an implant done at dental school, and would that idea be any better?

Also, my dentist first mentioned about getting a Catscan, but now he doesn't think it's neccessary. Is catscan really neccessary?

thank you!

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[DDSSlave]

I'm a 3rd yr student and know virtually nothing. Having said that....

First, what's wrong with 19 now? Missing? Pulpally involved? Periodontally involved? What's going on...

Second, you certainly can get an implant placed at most schools with a perio or oms resident and get the crown done by a student or pros resident.

A "CAT scan" or CT (Computed Tomography) is a processes of taking radiographic slices of the body. I would think this is overkill. Rather, he may be talking about Conventional Tomography which is similar but without the computer algorithms, etc and is much cheaper and accessible. This is almost standard of care I would think for anyone serious about placing implants. In your case, you would want the tomogram for two important reasons. 1- to see how close your inferior alveolar nerve is that runs through the mandible. You don't want to hit that. 2 - to see if the dimensions of the mandible support the angle at which he wants to place the implant without perforating the implant out the side of the bone. If it was me, I wouldn't get the implant from a surgeon unless they use this technology.

In all honesty I wouldn't get an implant place by someone so inexperienced. Most implant surgeries go well, but a small number of them can be disasterous if you can't manage the complexities, or so I've heard.

Hope this tides you over until someone more experienced can answer.

 

[cuspidarrow]

Thanks for the input. Yes, 19 was extracted about a year and a half ago.

How would I go about in getting the tomography you mentioned?

Also, if I do decide to wait until I'm in dental school, what options do I have to maintain the missing space? (my dentist wouldn't recommend a space maintainer).

 

[DDSSlave]

If 19 has been missing for 1 1/2 yrs you've probably lost all the space you're going to lose. Honestly you might want to wait until dental school so you can make a more educated decision. There may be other complications at play such as supereruption of the opposing tooth.

When you're ready to get the implant placed, the surgeon will probably arrange for the tomo. It wouldn't do you any good to go out and get it yourself.

 

[Supernumerary]

Who's to say the resident you get will be any more experienced than your dentist? Everyone's gotta start somewhere.

If he's been attending this seminar ~4 hrs/week for 5 months that's ~120 hours of training pertaining specifically to implant placement. I would guess that's a lot more than a perio resident gets before he places his first implant.

I guess what it boils down to is how much you trust the dentist. As his assistant you probably have a pretty good idea of his skill level. Is he meticulous and attentive to detail? Does he cut corners that shouldn't be cut? Does he already do a fair bit of surgery (extractions, flaps for perio, gingivectomy, etc...)? These are the kind of questions I would think about if I were making the decision for myself.