Hi, I’m Dr. Brett Langston. I’m a prosthodontist and owner here at Dental Implant and Aesthetic Specialist in Brookhaven, Georgia. I’m here to help you watch your mouth.
I wanted to take the time to answer any of the questions that people have asked in the comments, so hopefully you’ll get some answers to your common questions.
Can You Do an Extraction, Bone Graft, and Implant All in One Appointment?
One of the questions we get a lot is, can you do an extraction, a bone graft, and an implant all in the same appointment? The best way to answer that question is to start with what an implant is and what an implant needs to succeed.
So an implant is essentially a titanium screw that goes down on the bone, and once it’s healed, then we start the process of building a tooth on top.
So the most important thing for an implant to heal is that you have to have an adequate healthy bone, an adequate thickness of bone, and you have to have a healthy patient. So assuming you have a situation where there’s good bone, there’s good quality of bone, and there’s plenty of space, a lot of times we can take an unhealthy tooth out, place the implant in, and even if there’s not enough bone, we can pack some bone around there. So if there’s enough healthy bone around the tooth that needs to be extracted, a lot of times we can’t extract the tooth, place the implant, and put a little bit of bone around there to kind of close up the gaps and give the bone the best chance for growing around that implant.
Challenges of Bone Loss and Implant Success
Unfortunately, a lot of times there’s not an adequate amount of bone, especially that tooth that needs to be extracted, has an infection, or is unhealthy and has caused a little bit of bone loss around the area. In that situation, once we take that tooth out, that site is not ideal for an implant. And so at that time, we have to put the bone in, close everything up, and let it heal. And that healing process generally takes about two to three months at that point. Now we’ve got a nice solid thickness of bone, then we can go in and place the implant.
Unfortunately, that does add a little bit of time to the treatment plan from when you have the tooth taken out to when you can have a tooth put back in your mouth. But the most important thing for us is we want to give that implant the best chance of success. And if we put it in a compromised situation or if we put it in an area where there’s not enough bone, unfortunately, the majority of the implants are going to fail.
The Importance of Proper Timing and Quality Bone
And I know that’s probably not what you want to hear, everybody, and believe me, I would love that as well. I would love for every implant to be extraction, put a little bit of bone, place the implant, that way we can get to that tooth sooner because that’s one of the most frustrating things about implant treatment is it seems like time takes forever to go from losing the tooth to getting your replacement tooth. But through experience, I’ve found that it’s even worse if we rush things, because then at that point you may get the tooth earlier, but if that implant fails at a year or two down the road, then all of a sudden we’re back to the starting board and we’re at a compromised area that’s going to involve more bone grafting and more of a compromise that long-term implant. So the most important thing is making sure we’ve got good quality bone in that area when we place the implant.
When Can You Do All Steps in One Appointment?
Pretty much the only time that we can place implants, do extractions, place the bone graft, and actually put teeth on, the implants are on the bigger, more complex, involved cases. The cases that we call hybrid cases. And the reason we’re able to do that is because there’s a lot of pre-planning involved. We take three-dimensional cone beam images, we take intraoral digital scans, and before the surgery even happens, we kind of stitch everything together and virtually place those implants.
So we have a lot of parts and pieces. We have a lot of surgical guides. We have everything set up so that on the day of extractions and surgery, we know exactly where those implants are going to go. We already have everything built. On a traditional day-to-day single tooth implant. Unfortunately, a lot of times we have to extract the tooth and either place bone grafts or let everything heal before we can place the implant.
Contact Dr. Brett Langston About Your Dental Implant Today!
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