62 yo female had tooth #31 extraction with a successful bone grafting 4 months ago, now ready for single dental implant. Two different possible plans: 1) angled implant of #31 2) removal neighbor tooth of #30 and insert two straight implants #31 and #30. Which is the best plan: single implant is possible? or straight implant after removal another tooth?
Robert korman, DDS comments:
I would proceed with CT guided surgical planning to determine biological surgical and prodthetic parameters to decide.
Pros doc comments:
How about no implant? That implant will take a lot of force. We do 90 percent of our chewing from 1st molar forward so rarely a need to replace a second molar. Give pt. A nightguard so #2 won't supra erupt.
Tim Carter comments:
When in occlusion the opposing #2 is probably in contact now so the guard may not be necessary
Kent Mueller, DDS comments:
#2 is a liability ; CBCT may likely demonstrate a periradicular radiolucency approximating apex #2 // considering implant placement #31 position may later compromise #30 as it sits // consider implant solution for #30 when it fails, or as a proactive treatment. #2 may be sacrificed at any time to preserve health of #3.
angulation of implant placed in the #31 position may be more critical in the buccal - lingual degree , rather than the mesial - distal degree ;; must evalauate your CBCT information before considering placement here
Scott Bobbitt DMD MAGD DI comments:
I like no implant. Offer the patient a centric NG until such time as #2 needs to be removed. Better yet, extract #2 now to facilitate OH access to 3-D and have the patient put their dental budget into #30.
Richard Benian comments:
Can't make a decision without a CBCT, Get that first! You are treatment planning off a 2-D x-ray.