Dear Mr Rotar!
I am glad that I found your website with so much information and professional answers. Below I am sending you my own questions, for which I sincerely hope to receive your professional answer.
Because of persistent inflammation over many years around the upper left central incisor (since the age of 16; I am now 40), my new dentist advised me immediately at the first examination to have the root post removed and an implant placed by an oral surgeon.
I went to a dental surgeon for an examination and removal of the post. He believes that the defect is so large that he recommends an autologous bone graft and, in the next stage, placement of an implant.
I did not find information about transplantation on your website, and not much on other websites either. I would kindly ask you to answer my questions.
- Do you perform this procedure?
- Is the bone harvested from one site in the jaw (for example, one posterior side), or, if a larger amount of bone is needed, from several sites in the jaw (for example, simultaneously lower left, upper left, lower right, upper right)?
- What amount (cm3) can be harvested from one site?
- Can the harvested bone be used to replace the missing bone at the problematic site where I have the greatest defect (that is above the visible part of the tooth and upward toward the beginning of the mouth) with my own bone from another site in the jaw?
- How long does it take for the transplanted bone to integrate sufficiently with the bone at that site?
- I would also kindly ask how much the complete procedure, including all materials and your work, would cost me (how much for the transplantation, how much for the implant with its crown). Is payment made as treatment progresses?
- Waiting time?
- I would also kindly ask you to explain what alternative to an implant would be possible in my case, given that it concerns the upper left central incisor?
Thank you very much!
Sandra
Dentist Tomaž Rotar answers:
Dear Sir/Madam!
I follow the German school of Prof. Lang, who also teaches and works at a clinic in New York. In the case of a single missing tooth, we have never needed to place an autologous graft, and in my opinion this is also unnecessary. In the situation described, there is usually such a bone defect that an implant cannot be placed without replacing the missing bone volume. We replace the missing bone with synthetic or non-synthetic products Bio-Oss or Gen-Os (equine bone), together with placement of a membrane that separates the new bone from the soft tissue. The membrane dissolves on its own and does not need to be surgically removed. We usually perform both procedures at the same time: bone augmentation and implant placement. The osseointegration period is extended to 9 months. Price of the procedure: implant with bone augmentation EUR 1,000 + tooth/crown on the implant EUR 420 = EUR 1,420.
An alternative to an implant is a bridge, which requires preparation of both adjacent teeth, or an adhesive bridge (the tooth is bonded to the neighbouring tooth only with thin wings).
Have a nice day!