Q: Dr. Crapo: Two years ago I discovered that due to neglect I had lost a great deal of gum and bone support around my teeth. I started experiencing puffy gums around the lower anterior teeth. When my
dentist x-rayed my mouth, he discovered that six of my lower teeth, from left lower eye tooth to right lower lateral incisor, had lost too much bone support
to save them. These teeth were loose and expelled pus when pressure was put on
the gums surrounding them. I’m a medical professional and this was hard to
take. I’ve treated infection and disease all my life but I didn’t think this
silent mouth disease could be so devastating. In any case, I had intense
treatment over a number of months. In that time, the teeth were removed and I
settled for a partial denture. At first it fit tightly and comfortably but
lately the fit is not so secure. I’ve thought of implants and wondered if mini
implants would secure the partial satisfactorily or if there are better
options. I want to keep my teeth; however, I’ve been told that despite the fact
they feel solid, I’ve lost about half the bone on the roots of the ones
remaining. I’m committed to spending the time necessary to not allow gum
infection to invade again. It reminds me of heart disease, one day you’re
dancing and the next day you’re fighting for your life. I feel like I’m
fighting for my teeth. What do you think; will mini implants do the trick?
A: Just like heart disease that happens without
one’s perception, gum and bone disease (periodontal disease) can do the same. Now,
after treatment, if your mouth is healthy, two or three mini implants would
secure your partial very nicely. In certain situations, they’re ideal and less
costly than regular implants. If your remaining teeth had not suffered the bone
and gum loss, I’d say you’re a candidate for mini implants because future loss
would be unlikely (i.e.: if you’d lost these teeth in an accident).
Given that you are susceptible (I’m sure as a health professional you weren’t
derelict with your hygiene), I would suggest the placement of regular implants.
The reason is this – if you place minis and need more implants in the future
because of tooth loss, you will have to stay with minis. This will limit the
kind of treatment possible because prosthetically mixing minis and regular
implants is very difficult.
Place regular sized implants, then if needed in the future, regular implants can be
added and the prosthetic puzzle more easily worked out. It will ultimately be
less costly and you will be able to construct a stronger and better prosthesis.