erach27@[EMAIL PROTECTED]
wrote:
> On Mar 12, 5:33 am, mark.fer...@[EMAIL PROTECTED]
wrote:
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>> It looks as though I may soon need an implant to replace a molar in
>> my lower jaw (the molar nearest the front of my mouth, on the
>> left-hand side).
>
>> Almost all the dentists' web-sites say that implants 'feel totally
>> natural', but then, they're trying to sell implants!
>
>
>> But I believe that with an implant, you lose the periodontal
>> ligament, and with it two factors: the cu****oning 'natural
>> suspension' and the feedback to your jaw muscles (proprioception?)
>
>
>> This makes me wonder if chewing with an implant feels really
>> unnatural. Or does the periodontal ligament of the opposing tooth
>> make up for this, in effect doing the job for both teeth?
>
>
>> I'd therefore be very interested to hear what dentists in this ng
>> have heard from their patients on this subject.
>
>
>
> The following is from Open Wider: your wallet not your mouth page325
>
> There is a trend in dentistry that is starting to emerge from all
> this
> success wiht implants. If you go to a surgeon for an extraction,
> often
> they are selling you a bone graft so they may place an implant in 6
> months rather than waiting for bone to fill the space where the root
> of the tooth was. Of course there is a charge for the bone graft.
> These holes will almost always fill on their own. Extraction sites
> have been healing and filling with bone since the first teeth were
> extracted. It just takes a little longer, say 9 months.
>
>
> I had one patient who went to a surgeon to have a tooth extracted.
> The
> surgeon insisted on doing the graft even though the patient had no
> interest in replacing the tooth. Six months later the graft was loose
> and there was an infection in the area. The graft was being rejected.
> The patient now needed to have the graft removed and was left with a
> larger bone defect than if it had just healed normally without the
> graft. He still does not want
> the implant. Surgeons with somewhat elastic ethics insist on grafting
> all extraction sites. It does add a fee of about $300 per extraction.
>
>
> Endodontists, those specialists who do root canals, are getting into
> the game. Some of the more aggressive among them will look at a tooth
> that will be a difficult root canal and simply extract it and place
> an
> implant. Of course the cost of the implant is about 3 to 4 times the
> cost of the root canal.
> I can understand this if the root canal is impossible but I have a
> little trouble when it is done just because there is a difficult root
> canal.
> Some restorative dentists also do implants. If they see decay that is
> difficult and will require extra time to do a crown and maybe an
> implant, they will do an implant instead. The argument is that the
> crown may not last, so let's do the more predictable implant. Of
> course we will never know that the crown will not last if the tooth
> is
> removed and an implant is placed. Of course, the implant fee is many
> times that of a difficult crown and possible root canal.
>
>
> Implants work, but I fear they are being over prescribed. They are
> much more invasive and costly than a root canal or a difficult crown.
> Who should place implants?
>
>
> Well, clearly, oral surgeons are trained to do implants. The problems
> I have seen are that they sometimes do not align the implants very
> well. This makes restoring the case with crowns very difficult if not
> impossible. They also tend to be rougher with the gum tissue and the
> bone. Periodontists are my favorite implant placers. They tend to be
> much kinder to the tissue and the bone. Perio surgery is a much more
> precise surgery than removing teeth.
>
>
> I think general dentists should place implants. The techniques are
> not
> that difficult and the average dentist who is willing to take some
> continuing education courses and purchase some additional equipment
> is
> capable of doing implants.
> If you need an implant, I would suggest that you have someone who
> does
> 10 a month not someone who does 5 a year. They are technique
> sensitive. Do not do them just because it is easier to do than a root
> canal or a crown. While they are very predictable they do
> occasionally
> fail.
>
>
> Fred Quarnstrom, DDS
> Author Open Wider: your wallet not your mouth
matroshka
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