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About Zev Kaufman, D.D.S.
Expertise
I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.

Experience
Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Organizations
Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Education/Credentials
Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

You are here: Experts > Health/Fitness > Dentistry > Dentistry > Avulsed tooth - 10 years later

Dentistry - Avulsed tooth - 10 years later

Expert: Zev Kaufman, D.D.S. - 11/8/2009

Question
"Hi,

10 years ago, at 16 years old, I suffered an avulsed upper front tooth from a sports injury. The tooth was reimplanted and I still have the tooth to this day. I am currently 26.

However, my dentist has said that the original tooth is on its last legs. My understanding is that the root has been almost completely resorbed and the tooth is being held by the gum & muscles only. I can feel the tooth slowly becoming looser.

We do have a plan for when the tooth comes out. A temporary one-tooth denture will be made. I will use the opportunity to pull wisdom teeth and use braces to straighten

others. Subsequently, a permanent replacement tooth will be made and implanted with posts.

The idea of implanting an artificial tooth with posts does not appeal to me. Is any hope of permanently reimplanting my original tooth, perhaps with some modification, without suffering external resorption effects? Some googling reveals some creative uses of calcium hydroxide to pull this off.

Thanks so much for your time."

Answer
Dear Frank:
You should not wait until the tooth is ready to come out to start the orthodontic treatment. If the root of the tooth has been and is resorbing, then you should have the braces put on immediately. Straighten your teeth and while the braces are on, have the tooth removed carefully and and implant placed, possibly even at the time of the extraction of the remaining root, depending on your bone structure and anatomy.
The implant treatment plan is, by far, the best, most predictable, and long term treatment for your situation. Any other restorations such as a fixed bridge, a resin-bonded bridge etc. will give you a compromised result, since they involve the preparation of the adjacent teeth. The only other option which does not involve preparing the adjacent teeth is the removable denture (flipper). This is by far the lowest cost option, but it is the least durable and comfortable.
Calcium Hydroxide is used primarily for apexification (helping the tooth close the apex of the root as it forms). In your case it cannot be used, since your root is resorbing, and will continue to resorb until the tooth exfoliates.
I do not know what "with posts" means. An implant has three parts:
1. The actual implant which is placed into the bone.
2. The implant abutment which is connected into the integrated implant in the bone.
3. The crown which is placed on top of the abutment is is the final tooth shaped and colored structure you see in the mouth.
The implant procedure itself is routine, in the right hands, and very predictable.
I would advise you to go and see a Prosthodontist, which is the specialist in restorative, cosmetic, and implant dentistry, even prior to seeing an orthodontist. There are many advances in esthetics today that the Prosthodontist can advise you and guide the orthodontist in proper placement of the teeth for ultimate results. Remember that you are very young and the work has to serve you for many years. I strongly urge you to go to the appropriate specialists and get the best work done possibly. It has to last you for years to come.
www.prosthodontics.org will have a link to locating a Prosthodontist near you, or just call my office and I'll gladly refer you to a colleague in your area.
Best of luck,
Dr. Zev Kaufman

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