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Question:
I've had two implant failures, both of the early variety. The 1st failed right after the 1st tempoary was removed.
The 2nd failed a few days after the second temporary was put in place. In both cases 3 - 4 months expired between implant installation and temporary installtion.
My Dentist now wants to try a 3rd time. I'm losing confidence in him in his ability. Any advice or recommendations? ...Visitor from NY
Answer:
A third implant placed in this site can succeed even after 2 implant failures.
Are you saying that this implant was temporized immediately after placement? Temporization of implants immediately after placement needs to be done with great care.
I find that most dentists do not appreciate the nuances of immediate temporization. Formal coursework on these techniques are scarce. I should know because I just started to teach a 22 hour course on these techniques.
Even after participants finish my extensive course I do not expect the participants to be able to render care in a highly successful manner until after they have treated several cases.
My advice to you is to seek a specialist who has a 3-Dimensional x-ray machine and performs dental implants regularly. A determination needs to be made on the quantity of bone. 2 implant failures can often lead to a deficiency in bone. The need for augmentation procedures needs to be investigated with the use of the 3-D x-ray machine.
Immediate temporization can work when the anatomy and the bite are acceptable. I would not expect to perform immediate temporization in a case like this.
After one failure, my suggestion is to remove as many variables as possible to help ensure success. For example, place the implant in the bone and under the tissue in a submerged fashion.
Then check the implant once/month with regular dental x-rays to be sure that normal healing is occurring. After about 3 months, expose the implant and proceed with getting a tooth on the implant.
Edward Brant, DDS, MS
Reconstructive Periodontist
447 Lake Avenue
St James, NY 11780
(631) 584-4395
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