[RPM33]

Originally Posted by RickFLM4

Anyone have a dental implant or bridge (one tooth)? If so, are you happy or would have have made a different decision than the one you made? I can do either (or just have one less tooth) and leaning towards dental implant over bridge.

I got two implants one year ago. They are expensive ($7,500 for both out of pocket with insurance). It is worth it as they look and feel like real teeth.

The $7,500 includes for me the removal of the two rotten teeth, two implants, and two customized made crowns to match your existing teeth. Hopefully you have better dental insurance than me.

[RickFLM4]

Originally Posted by RPM33

I got two implants one year ago. They are expensive ($7,500 for both out of pocket with insurance). It is worth it as they look and feel like real teeth.

The $7,500 includes for me the removal of the two rotten teeth, two implants, and two customized made crowns to match your existing teeth. Hopefully you have better dental insurance than me.

Our insurance is just starting to cover implants in 2024 (coincidentally- decided to do this before I knew they were adding it). But OOP max is much less than cost of implant and crown so I expect to be OOP around $5K or so. Is what it is.

[RickFLM4]

Originally Posted by RickFLM4

Welp, a year and 1/2 since this settled down, the crown started to loosen and it became time to deal with this. Started the implant process today by removing the crown, getting out what was left of the old roots below that and doing the bone graft. 2+ hours in the chair (a lot of which was getting right level of local anesthesia and talking to my dentist, who has done hundreds of these procedures). Removing the remnants of the roots was difficult but it is done. I thought they were removed completely with the root canal (by another dentist long ago) but they weren’t.

Well I finally finished with the first implant and the first step I quoted above was (by far) the worst of it. Specifically, I ended up with some pretty bad TMJ pain for close to a month last December and January, right through the holidays. I also managed to crack a tooth on the other side of my mouth, which resulted in an infection. My dentist referred me to an Endodontist for a scan to see if he could save the tooth with a root canal and he recommended we not even try and go straight to an extraction on that one. Fortunately that extraction went a lot better than the first one.

Once I got past the TMJ pain from the first extraction, the rest of the process wasn’t bad. The bone graft and overall recovery went well. Implant stability score of 78, which sounds like a C+ to me, but I’m told is very good. There are several steps but overall I’d say it’s not bad and I’m very happy with the result. Total OOP cost was about $4K as insurance maxes out at $1,500/year.

Now I am planning the do a second for the cracked tooth that got extracted. I'll probably get the implant this year so I can get the crown early next year when my deductible re-sets. Also want to wait a bit to make sure I’m still happy with the first one before proceeding to a second.

[iX nOOky]

I am getting an implant May 29th. Maybe. I had my upper front tooth slowly die from resorption, and it was removed in December last year. At the time my dentist didn't want to talk about bone grafts until it healed because he wasn't sure how it would look after healing.

Now I wish I had pushed for an implant back then, because when they go to do the procedure in May I may end up with different outcomes. One is he does a bone graft at that time because there may not be enough bone. Two is that he does the implant and is able to pack some bone graft material at the same time. The last is that there is enough bone and the implant proceeds normally. I was told he wouldn't be able to tell until he got into it, which is kind of a bummer.

It will be expensive, but hopefully worth it. I'll pay for it out of pocket, but keep the receipts in case I want to draw out of my HSA later on. It appears to be a long process of healing between steps.

[RickFLM4]

Originally Posted by iX nOOky

I am getting an implant May 29th. Maybe. I had my upper front tooth slowly die from resorption, and it was removed in December last year. At the time my dentist didn't want to talk about bone grafts until it healed because he wasn't sure how it would look after healing.

Now I wish I had pushed for an implant back then, because when they go to do the procedure in May I may end up with different outcomes. One is he does a bone graft at that time because there may not be enough bone. Two is that he does the implant and is able to pack some bone graft material at the same time. The last is that there is enough bone and the implant proceeds normally. I was told he wouldn't be able to tell until he got into it, which is kind of a bummer.

It will be expensive, but hopefully worth it. I'll pay for it out of pocket, but keep the receipts in case I want to draw out of my HSA later on. It appears to be a long process of healing between steps.

I’m not a dentist and every situation differs, but having been through 2 implants I would opt to have the bone graft done and wait at least a couple of months before thinking about the implant and then at least a couple more months before getting the osseointegration tests and measured for the crown. The last thing you want to do is get the implant and have it fail, which is what happened to my BIL. My dentist did the bone graft on the same time as the extractions in both cases (but your extraction sounds more complex) and I am fortunate in how well the bone regenerated in both cases.

Hopefully your dentist does these all the time. There are a number of steps and quite a few office visits. Can’t be rushed and whoever is doing it needs to be an expert. Even if the process goes well, there is always some level of risk the implant will fail, but it is well worth the cost and the process when works out as it should. But having someone who really knows their stuff greatly improves odds of success.

Best of luck and let me know if you have any questions from a patient perspective.

[DocL]

As a dentist, a upper front tooth is a different situation in regards to a posterior tooth. The issue being the width of the alveolar ridge, and where the gingival crest is in relation to the adjacent teeth. When the surgeon I refer anterior teeth for extraction, we always place a bone graft. Depending on the quality of bone we can sometimes immediately load the implant and guide the tissue with a provisional abutment and crown. I usually allow six months for the tissue to conform before I fabricate the final crown.

I hope you are having a Periodontist place the implant. It's not the placement that is difficult, well sometimes it is, it's managing the tissue and emergence profile that is challenging with implants. I've seen some really bad disasters with front teeth that make Mr. Ed's teeth look like a Miss. America smile lol.

[Roadcrew]

I use to have 2 implants but lost one. My first was a single post and 2 teeth representation implanted lower center. Was 3 or 4 grand, forgotten how much. Insurance did not cover it. The left eye tooth was slowly wiggling it's way out. Finally had it pulled. Dr want to do another implant and since the first one was great I thought why not. Needed a bone graft first. The process took 6 months. Then had the implant installed. New implant healed nicely. About 2½ years later started to fail. Dr made valiant effort to save it to no avail. That was 6 grand. Treatment option now was to do a bridge for another 5 grand. I declined. That would be a 12 grand tooth. I'm not particularly vain about my appearance but really at 73 who cares.

[DocL]

Originally Posted by Roadcrew

... The left eye tooth was slowly wiggling it's way out. Finally had it pulled. Dr want to do another implant and since the first one was great I thought why not. Needed a bone graft first. The process took 6 months. Then had the implant installed. New implant healed nicely. About 2½ years later started to fail. Dr made valiant effort to save it to no avail...appearance but really at 73 who cares.

The canine is a difficult tooth to replace with an implant. When you move your jaw laterally, it absorbs all of the forces of occlusion. A implant is fixated to the bone and those lateral forces can cause stress on the bone leading to failure. If the occlusion isn't balanced these single tooth implants can be very tricky to restore. Also, the buccal plate is egg shell thin in that area which can result in a fenestration of the bone. Sometimes the patient has to be put into group function to help spread the forces evenly on that side of the mouth.

Dentistry isn't as simple as people tend to believe unfortunately.

[iX nOOky]

Originally Posted by DocL

As a dentist, a upper front tooth is a different situation in regards to a posterior tooth. The issue being the width of the alveolar ridge, and where the gingival crest is in relation to the adjacent teeth. When the surgeon I refer anterior teeth for extraction, we always place a bone graft. Depending on the quality of bone we can sometimes immediately load the implant and guide the tissue with a provisional abutment and crown. I usually allow six months for the tissue to conform before I fabricate the final crown.

I hope you are having a Periodontist place the implant. It's not the placement that is difficult, well sometimes it is, it's managing the tissue and emergence profile that is challenging with implants. I've seen some really bad disasters with front teeth that make Mr. Ed's teeth look like a Miss. America smile lol.

Thanks for your comments. My dentist is not placing the implant, he was worried about hitting the nerve up there and recommended a professional oral surgeon that specializes in implants etc. My dentist will place the tooth on the implant once it's done.

The guy doing the implant is the most experienced one in the practice, he comes very highly recommended and is very experienced. I'm trusting his judgement on what to do.

[iX nOOky]

I had it done today. He placed the implant, bone graft, and the abutment thingy. I go back in 3 weeks to have some stitches removed and for a quick peek at it, then 3 months to see how the healing is progressing.

[Bald Guy]

My dad's almost 80 years old and has been having issues for a long time. My mom is okay for now, but both have been having their hurdles off and on. I feel bad for them, and I'm trying to guide myself in a better direction.