The last thread on this topic was in 2010 so I thought I would see if anyone has experience with newer techniques. I had to have a molar pulled from my upper jaw and my choices are implant or bridge. My dentist strongly encourages the implant since the bridge would be large and require grinding down a perfectly good anchor tooth.
First I went to an oral surgeon for a consultation. He said I have only about 6mm bone between my gum and sinus, so he described a procedure for sinus lift that sounded very long and painful. First he would remove bone from the back of my gum line and put that between the sinus and gum. The procedure involved surgery through the gum and trauma to the sinus. After a long wait (many months) he would then do another surgery to place the implant. I must have glazed over at some point because the conclusion after the consult was that I would go for the bridge.
My dentist talked me in to a second opinion with a periodontist. This guy has done lots of implants, 10’s of thousands by his estimate. He described something called an “internal” sinus lift, where graft material is placed at the time of implant placement. The sinus gets bumped up a bit as the material is put in place. I’m opting for this once I research the success rate. Insurance pays half of the implant surgery, so the extra cost compared to the bridge is not excessive.
Anyone have experience with an “internal” sinus lift?
No experience, but I have one bridge on one side and the same tooth an implant on the other side. I must have an odd bite. The bridge was done before implants were offered. I like the implant better.
No experience with this particular surgery but I would opt for grinding down another tooth rather than undergo what you describe. Anything dealing with the sinuses can be very painful. Why put yourself through all that when there is an alternative that seems far less complicated?
edu8me - I have the exact same issue, except my body has developed an intolerance to pain killers…so everything is on hold…not good. It has been almost a year and I am still very self conscious of the gap in my mouth where the molar used to be. I find it embarrassing.
If a bridge is an option, I’d consider it. I have 3 implants in the front. Also had not much bone so had to have bone grafts. It ended up being a long and miserable process (I suspect I was not really a good candidate with the amount of bone loss I had and the infections). Since then, my sinuses are constantly inflamed (has been diagnosed as chronic sinusitis). I do like having front teeth I can actually bite food with, hated the temporary false teeth. But, I would not go through the process again if the need arose.
It was a while back, but I believe I had exactly what you’re planning on doing after I cracked an upper molar in half and it had to be pulled. My process: pull molar, pack with grafting material (wait ~3 months); check graft, “raise” sinus and pack with more grafting material (wait another ~3months); place implant (wait a month or so); finally get actual tooth installed on implant. The whole shebang took almost a year and was hella expensive… easily maxed out my wimpy dental insurance and medical wouldn’t touch it.
My rationale at the time was that I had all my teeth, they were in good shape and I just wasn’t ready for a bridge. And we could afford it.
Absolutely no regrets. A dentist buddy of mine said that (done correctly) the implant will outlast the rest of my teeth.
Thank you for all the comments, I agree with everything said. Four years ago I had an uncomplicated (no sinus lift) implant of the same tooth on the opposite side. I like the way it feels and apparently the implant helps to maintain bone health in the jaw. I asked both the dentist and the periodontist about sinus complications and both said I wouldn’t notice any difference (the dentist has nothing to gain by saying this). However people with pre-existing sinusitis issues are not good candidates. The periodontist said people’s sinuses expand with age (like everything else!) so even with the lift the sinus volume would be greater than when I was younger. The technique he proposes doesn’t involve any surgery on the sinus, just a slight displacement from below. And the most appealing aspect is that the implant and sinus adjustment take place with a single one hour procedure.
I did some searching of scientific publications on implants and the number of studies has been increasing dramatically over the past few years, perhaps because insurance is now covering part of the costs. It gives me hope that the technology is advancing faster than my teeth are failing. I have to wait until January to get anything done to make full use of my insurance coverage so it gives some time to think about it.
Kajon, regarding pain, after the last implant I really only needed ibuprofen for a day or two, it was no worse than most dental procedures. Certainly it was no worse than an abscessed tooth, that’s the worst! I am sort of used to the gap now, it just makes me eat really slow which is a good thing. Since this issue came up I’ve been surprised at how many people say they are doing just fine with a tooth missing here or there. I’ll update in January if I decide to go through with it.