Expert: Lawrence Spindel DDS, www.lspindeldds.com - 11/3/2009

Question
Dear Dr. Spindel: I recently lost a crown on a tooth that had been root canalled in the back upper right region - the very back, not a wisdom tooth.  My dentist told me that doing an implant in that area is very tricky because of the closeness to the sinus. He said a gap in the back there would probably not affect my bite or be a problem.  But I wanted to know: can a successful implant be done there?  I did see on X-ray that it was close to the sinus and that concerned me.  The tooth is still there, what's left of it, and I also wondered if I should get a second opinion and see if the crown can be replaced.  What do you think?  Thank you so much, Matthew

Answer
Dear Matthew

I do believe that a second opinion is in order.   I would advise you to make an appointment with a specialist such as a Periodontist or and Oral Surgeon. Both of these specialists can advise you on whether a sinus lift, either partial or complete, is feasible. Usually if a molar is in place, than there is enough room for a partial sinus lift. A Partial sinus lift is less invasive than a complete sinus lift and involves displacing the sinus only in the area immediately apical to the socket. Usually it involves only a small surgical area and recovery is quick.

Also when you go for your consult ask whether restoring your molar is a good option or not. It depends on the amount of health tooth that remains and whether your root canal is still working well.

I hope this information has been helpful and please feel free to contact me again with any future dental questions.