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Oral Surgery/Dental extraction and implant procedure

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Question
Hi Dr Teig,

I have a question regarding the procedure of removing a single molar (UR-5) followed by an implant.

Some background information, I am a 33 y.o. male and require the molar (which is a milk tooth, adult never grew to replace) to be removed as there has been an abscess for the last 3 months.

An Oral surgeon and my dentist have described two conflicting steps for the extraction and implant, which has left me confused on what to do.

The oral surgeon will extract the tooth, wait for 3 months to allow for maximum healing, then insert the implant. Separate procedures at later dates will follow to insert an abutment and another to place the crown.

My dentist, whose clinic also performs these procedures, has advised that the best way is to extract the tooth and immediately insert the implant (osseous grafting involved). Thereafter I will wait 3-4 months to allow for healing around the implant. Separate procedures at later dates will follow to insert an abutment and another to place the crown.

Your input will be greatly appreciated as I keen to have this done as soon as possible due to pain and discomfort from the abscess.

Thanking you in advance.

Carlos

Answer
Carlos - There is absolutely no choice here.  The dentist is absolutely wrong.  Just like surgery anywhere, the elimination of infection before any surgery is important and insures a better success for the implant.  I have seen other dentists who also attempted the implant immediately or even a few days after the removal of an infected tooth.  99.9% have failed and the patient has suffered after the implant placement with pain and infection.

So do yourself a favor and follow the recommendation of the oral surgeon.  You will be much happier and satisfied with the results.

If you have further questions, feel free to contact me again.

Oral Surgery

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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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