Dental Implants - Central incisors

by Tom
(UK)

Hi,

I was born with hypodontia and i am missing a number of my adult teeth, consequently i have lost a large amount of bone.

I recently underwent bone grafting in the maxilla / mandible to correct the disproportion of bone and prepare my mouth for implant placement. My own bone was used for grating.

I had a number of baby teeth in my maxilla extracted during the operation, leaving just one central incisor, my molar's and pre-molars in place.

I am currently awaiting implant placement in 45days, in total my oral surgeon wants to leave a four month time frame between the bone grafting and my forth coming operation.

My oral surgeon / restorative dentist are now planning to extract my central incisor and replace it with an implant as they feel this will have an overall better aesthetic outcome. They are planning to do this in the next couple of weeks so that the socket has time to heal. My oral surgeon has stated that the central incisor socket will not need to be grafted.

1.) If I have the central incisor extracted now - will the socket / bone have enough time to heal before I have the implants placed in around 40 days

2.) If a central incisor need to be extracted for implant placement is it normal to not graft the socket? Will I not lose a lot of bone if the socket is not grafted / experience bone resorbtion around the socket whilst it heals. Could I end up with a dry socket?

3.) Will the long term success rate of the implant be jeopardised because of this. I am concerned that the foundations around the central incisor will be inadequate leading to poor implant stability

4.) I am having a cone beam scan to determine how much bone is available / where the implants will be placed. At what stage is a bone graft determined successful / resorbtion stops. How long does it take for the bone to granulate?

I ask these questions as i still have some bone graft material that is visible / coming through in the mandible area where the gum tissue has not healed fully. Will this be a problem and is this normal after two and a half months post op. I have spoke to my oral surgeon and he does not seem too concerned however other dentists are.

I would be very grateful is you could share your expertise on this matter, thanks