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Dentistry/Dental implants and root canals

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QUESTION: Hi Doctor!
1)If a patient has only residual roots of a tooth left (at/or below the gumline) following an old root canal and that patient wishes to replace that corroded tooth with an implant - will the removal of the rest of that root-canaled tooth be more extensive and expensive for the dentist than a regular "residual root removal" of an untreated tooth?
2)I've been hearing a lot in the past couple of years about "mini implants". Does that simply mean the replacement of 2 neighboring teeth?
3) Will most dentists promote the removal of damaged... albeit "healthy" teeth if most of the patients other teeth are missing  or far beyond ordinary dental repair and the patient has requested implant replacement for all?
Thank you in advance for your time.

ANSWER: Amanda - If the residual roots underwent root canal treatment, that treatment does not necessarily makes the extractions more difficult. Some retained roots with root canal treatment previously can have a very dense bone surrounding them from the chronic inflammation.  In that situation the extractions can be more difficult, but in most cases the extractions are no more difficult than roots without root canal treatment.

2) Mini implants are actually implants that are very small and thin.  This situation makes the placement easier, but these implants cannot handle forces in chewing in many patients in some areas.  So in certain situations these minis are okay, but the regular implants are better at dealing with more chewing forces.

3) The reason and plans to restore a normal bite are the best criterion to decide which teeth might need removal.  Just because other teeth are missing and implants are planned, it is not a reason to extract teeth.  Very often a plan to keep teeth and placement of implants in the spaces is felt to be a proper solution.

If a patient wants  all their teeth removed and implants placed, an  honest dentist needs to evaluate and decide if that is appropriate.

---------- FOLLOW-UP ----------

QUESTION: Thank you very much for the quick and informative response, I've given you a 10/10 rating. I have Osteogenesis Imperfecta and a side dose of Dentogenesis Imperfecta. I only have 12 teeth left at this point as a result. The root canal teeth...even the ones that were crowned, have simply fallen apart. The teeth that received large fillings also simply died on their own and had to be removed. It's sad. I have nightmares about losing My teeth every other night now. I'm an attractive young woman and I'm fed-up with creating My own dental prosthetics using products from Micheal's craft store (yes, you read right). I've considered just pulling the rest of My teeth and having implanted dentures installed but I have reservations about pulling healthy teeth (as you noted, most dentists would as well). Can an implant be installed that replaces neighboring teeth (an implanted partial, basically)? That may work for My situation best. Thanks again, Doctor.

Answer
Amanda - Implants placed to facilitate a partial denture or a bridge is a good solution for those with a loss of a number of teeth. I, of course, do not know your financial situation, but if you want the functionally best and cosmetically best result, you should probably be examined and treated by a dental specialty called  a prosthodontist.  These doctors specialize in regaining the best bite and dental appearance.  They are highly skilled.  I am sure there are some near you, but it may take a little looking to find one.

I wish you well and hope your situation can be corrected to make you totally comfortable with the result.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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