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Oral Surgery/Bone Grafting/Implants

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Question
Do you recommend an oral surgeon over a periodontist for implants/bone grafting? I have significant bone loss on around lower molars (I am a heavy bruxer). They have Class III mobility per the periodontist so they need to be extracted. I will need bone grafting and 4 implants.

Also, what is the likelihood that bone won't be able to be restored enough for implants? I am 45 really would be disappointed if I can't get implants. Can you get more bone density using your own body versus sterilized bone?

Thanks for your time.

Answer
Melissa -  periodontists are doctors who do mostly minor tissue repair with occasionally some grafting.  Oral and maxillofacial surgeons are doctors who do surgery every day.  They are familiar with the characteristics of the bone and are more familiar and trained in the techniques of repairing bone.  Oral and maxillofacial surgeons have been doing implant placement much longer than any other dentist.  These doctors have used bone implants for repairs of bone trauma or degeneration.  So the oral and maxillofacial surgeon is the type of doctor who is better trained in surgery, bone grafts and promoting healing.

Depending on the location where the bone was taken from and the characteristics of the tissue in the site where the graft will be placed, the density of the bone can be varied.  For that reason along with your bone, sterilized bone from other sources are often added to increase the density.  So each person is different and the situation needs to be evaluated during the surgeon to determine the appropriate type of bone used.  


With the many different types of implants, bone restoration can almost always be done to facilitate implant placement.  For that reason, the oral and maxillofacial surgeon who does bone placement in the repair of fractures of the jaw and to facilitate cosmetic improvements when total facial reconstruction is done.  So the surgeon would be the appropriate doctor with the most chance of success.

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Volunteer


Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon 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 practicing for over 20 years. Assistant Clincal Professor at 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 Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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