Dental Implant Process: What To Expect When Getting Dental Implants?

[@rickdams]

Great presentation, I am within a week of getting final crown but have been pretty frustrated at the time it takes. Your explanation at the beginning of the process would have helped me avoid most of the frustration and speculation about my dentist and oral surgeon.

[@BhatiaDentopulse]

nice information.keep it up

[@Floodland-bn3ol]

Brilliant video doc. Learned so much.

[@johnjazayeri]

Thanks for watching my video! Feel free to put your questions in the comments below and I'd happily answer them. Want to schedule an appointment to see me? My offices are located in Southern California (Orange County). Click below to schedule an appointment: San Clemente Office: www.oceansightdental.com/book-your-appointment-online/ Newport Beach Office: genuine.dental/

[@teresathreatts4266]

There is a place where implants are done in a day. I had my consultation (ct scan, etc) on the first day. Sure, the process overall (specifically the healing) takes time. I have a full-mouth restoration...and I had it done in a day...surgery on one day and the implants placed on the next day. I had my teeth done at Nuvia...and it was a FANTASTIC experience!

[@inkbold8511]

Implant in a ray usually mean just putting the screw in the same day as the extraction. However, the final part of the implant ie the abutememt and crown is 3-5months wait period.

[@inkbold8511]

Ray=day

[@teresathreatts4266]

@@inkbold8511 Correct...I'll have the final part of it conducted in August! I had the initial part completed in March.

[@Brancaalice]

I love your videos, keep posting, there lot people go blind to dentists and didn't know what they did. One question: Does oral surgeon do bone harvest for bone graft or patient have get another surgeon to do it?

[@johnjazayeri]

Hi Alice. Glad you're learning about teeth! I'm not quite sure what you mean by bone harvesting, so I'll go over a few different scenarios: 1. Can your dentist/oral surgeon harvest your jawbone for your own treatment? Sure. A lot of times we cut jawbone from one site and graft it into another. For medium-sized defect, we use the jawbone from the chin or condyle of mandible. For massive defects you will have to go to the hospital and have bone harvested from your ribs, hips, etc. Of course, these are both last resort options when standard grafting options are not going to work. 2. Can your dentist/oral surgeon harvest your jawbone for future use? They are now using wisdom teeth to harvest stem cells. Crazy right? But if you want to harvest stem cells from your wisdom tooth then that's something that your dentist/oral surgeon can assist you with (for a hefty sum of course!) 3. Can your dentist/oral surgeon harvest your jawbone for use on others? No. Most of the bone grafts used by dentists/oral surgeons is sourced from cadavers of donors. You can not donate your jawbone or use it on someone else.

[@EL-yi6df]

I'd appreciate your feedback on several issues: 1. Submerged vs. non-submerged implantation. When is ok to do a non-submerged implant. 2. 31 32 41 42 (European numbering) extracted, two very deep 13x3.75 MIS implants placed submerged. My maxillofacial doctor said that no need for socket preservation and ridge augmentation (a waste of money.) 3. Please elaborate on platform switching. 4. Pure titanium (softer?) vs titanium-alluminium (stronger) alloy. 5. CEREC zirconia (crown) restoration. Pros and cons. When it is not recommended? Thank you a lot in advance.

[@johnjazayeri]

Hi E.L. Very detailed questions, therefore allow me to provide you with equally detailed responses: 1. Non-submerged implants are whenever your dentist places a dental implant and attaches a healing cap to bring the implant ABOVE the gum-line. The benefit of doing this is you won't need a 2nd stage surgery to expose the implant because the implant is already above the gum-line. The risk is that exposed implants have a higher failure rate as they get exposed to saliva and bite forces. I only recommend placing exposed implants on patients who are very healthy, non-smokers, have high-quality bone, are able to follow instructions, etc. Also, I usually prefer burying my implants whenever I do immediate implants (that is tooth extraction at the time of implant placement) or extensive bone grafting (since you can not achieve primary closure when implants are exposed). So while convenient, most of the time it's better to bury the implants and then expose them via 2nd stage surgery. 2. Lol, your oral surgeon is very straight to the point. He is partially right, although there is one issue he is overlooking. For implants in the anterior region, which is where your implants are, bone grafting is not that important. This is because there are no vital structures in the front of the mouth. The same can not be said of back teeth where there is the sinus (upper back teeth) and the IA nerve (lower back teeth). As a result, bone grafting is much more important for back teeth as compared to front teeth. In the front region, you can place a dental implant even if there is significant bone loss. By placing a longer implant, you can create a longer abutment/crown to fill in the defect. The only issue with what your oral surgeon said, and this could be a major problem, is that the implant crown ends up being really long when there is a major defect. A long crown means the abutment can get loose, the crown may fall off, it may look ugly, and you get a ton of food trapped in the large gap between the implant and neighboring teeth. So while the bone loss in the front region may not directly impact the surgical placement of the implant screw, it can have a negative effect on the esthetic, comfort, and longevity of the implant crown itself. 3. Platform switching means that different implant sizes require different abutment sizes. It makes the implant system more complicated to work with since you will have to know the implant brand as well as the width of the implant. So with Nobel implants, there are 3 different abutments, each one that corresponds to a different implant width. A non-switching implant system has a one size fits all abutment system so you can use any abutment to restore any implant. This makes it easier to work with the implant, but it also slightly increases the chances of the abutment getting loose over time. 4. Titanium alloys come in grades 1, 2, 3, 4, and recently 5. I believe grades 4 and 5 are suitable for dental implants. These alloys contain small amounts of metals including iron, aluminum, etc. Pure titanium, as you mentioned, is too soft to be used for dental implants by itself. 5. CEREC crowns are 3-D milled crowns. Dentists who offer CEREC technology can make their own crowns in-house. They scan your tooth, design your crown, and 3D print the crowns themselves. Pros: Crown can be done in one day. Cons: Harder to do complex cases. I generally find CEREC crowns only useful for individual crowns, inlays and onlays. For complex cases with 6, 10, 12 crowns, as well as cosmetic cases like porcelain veneers, I find it easier and better to send my case to a reputable laboratory and have them design and fabricate the crowns instead.

[@EL-yi6df]

@@johnjazayeri Thank you so much for devoting time and sharing some thoughts regarding my questions.

[@EL-yi6df]

@@johnjazayeri One more topic. A zirconia milled multi unit implant bridge: - The connector(s), i.e., the link between adjacent teeth, seems to be weaker than a similar PFM's connectors. Therefore the milled zirconia connector(s) is (are) very massive. Which makes it harder to clean the between the units of the bridge and probably a little bit less aesthetic. Is that correct? - Milled zirconia crowns (CEREC for a single unit, lab made for a multi unit) impressions were done digitally (intra oral digital scanning). The crown(s) seem to go bellow the gum less deeper than a PFM restoration. I rather prefer the crowns to go deeper bellow the gum line. Unclear for me if the digital impression inherently means not placing a tissue retraction cord. In other words, can and shall a tissue retraction cord (and the variants) placed and only then a digital impression be taken? Having the restoration going below the gum line deeper (as PFM restoration), is that impossible due to the digital scanning, or is due to the usage of zirconia? Thank you a lot.

[@aparnasingh2019]

Hello Sir, thank you for the detailed explanation of the procedure. I have a missing first molar on the upper right jaw for the last four years. However, roots of that missing tooth are still inside. The doctor seriously mishandled my case. Even I was not very aware of the significance of the missing tooth that time, but now when I read about it, I get scared of the long term consequences. I have consulted a doctor who told me that my bone height in that area is not adequate which is why implant is not possible and the process of bone grafting could involve complications since it is really close to sinus nerve. The doctor suggested that I should go for bridge. For that, he is proposing that he will first extract those roots and then explore my alternatives. Sir, could you please suggest what should I opt? Also, is it risky that I still have those roots of missing tooth inside my jawbone. Really looking forward to your advice, sir. Thank you sir.

[@johnjazayeri]

Hi Aparna. Excellent questions. Here are the answers that you're looking for: 1. Is it dangerous to leave root tips inside my mouth? Yes. Root tips can become infected and drain pus into the body. Unfortunately, the most dangerous area for leaving root tips happens to be the upper back teeth. These teeth are very proximal to the sinus membrane. As a result, they can easily drain pus into the sinuses. This causes tons of medical problems. It's even more dangerous if the tooth has previously had a root canal treatment. Check out my video to better understand what I'm talking about: kzbin.info/www/bejne/lXrWhGinr9iaaac 2. Should I do a bridge because a dental implant is too "risky" according to my dentist? No. Get a second opinion from a dentist who specializes in dental implants. Sure, there are some risks with dental implants as there are with any other surgery. However, let's talk about the risks of placing a bridge. Placing a bridge damages two good neighboring teeth. These teeth may end up getting infected and need a root canal treatment. Worse case, the teeth could fail within a few years. Now you have one or two more missing teeth than when you started. You now need one or two more dental implants to replace these missing teeth. I've treated hundreds of failed bridges with dental implants over the years. Personally, I would go for the dental implant every single time. Are there reasons to favor a bridge over a dental implant? For a patient who is missing only one tooth, I would say very few reasons. Check out my video to learn more about when to do a bridge and when to favor a dental implant (and the answer almost always favors the dental implant over the bridge): kzbin.info/www/bejne/f3q5hZeQmZedbNU I hope this helps answer your questions. Good luck with your treatment!

[@aparnasingh2019]

@@johnjazayeri thank you so much for your prompt response. No doctor has ever addressed my concerns this patiently. I am really grateful to you. I will seek another opinion and hopefully my treatment goes well. Thank you for your time, sir.

[@leo94086]

In 1987, I have #30 and 32 extracted and a bridge on 29-30-31. In 2001, infection on 31. Root canal was done on 31 and a new set of bridge. Now, infection on 31. Should I do implants on 31 and 30? Or should I do implant on 31 and new set of bridge on 29-30-31. There is noticeable bone loss on 30 since it is gone for 37 years. Please advice. Thanks

[@johnjazayeri]

Hi Leo. The best treatment is to place a dental implant implant for #30 and #31, and put a crown on #29 (or cut the bridge and keep the existing crown on #29 if that's possible). The fact that #30 has been missing for 37 years is not that important. If there are teeth on both sides of a missing tooth, as is your case, there should be enough bone for a dental implant. Lastly, I don't understand how you can do an implant on #31 and a bridge from 29-31. You can NOT connect a natural tooth to a dental implant. If you were to lose #29 as well, then you could place an implant in positions 29 and 31 and place an implant bridge on 29 and 31. However, if you have a dental implant #31 and a natural tooth #29, you can't connect these two. I hope this helps, and best of luck. Let me know what you end up doing.

[@leo94086]

@@johnjazayeri Thanks for your reply. Very useful and highly appreciated,

[@doublejump6578]

I am in the end stage of my front teeth , my 2 front teeth, on the 28 th of August I get my 2 front teeth, has taken about 3 months so far and cost me 8 300.00 I just paid no financing , it’s better to just get them paid for if possible. If you have no money , and finance is the way then do so any thing is better than not having 2 front teeth . , this has been all my life with out front teeth, I am worried and excited worried if they are not made properly, it could look badly, excited because it’s been years with damn flipper in my mouth

[@johnjazayeri]

Hi there! Sorry about your frustrations, but I'm glad you're finally getting your front two teeth back! Here's what you need to know about the process: There usually is sufficient bone in the front to place dental implants. If not, a bone graft usually gets the job done. The biggest issue here, especially if you've been missing the teeth for decades, comes down to the way the teeth will look at the end. Your implant teeth may end up being longer than your other front teeth. This is because of the bone level dropping after years of not having teeth in place. Ultimately, the implant teeth end up being longer than the neighboring teeth. Now, if your upper lip covers the teeth, this won't matter too much. However, if you have a gummy smile, it will definitely show. The shortcut is to add "pink porcelain" to blend in the long tooth with the gums and other teeth. The longcut is to do a bone graft, a complex one, to raise the jawbone height, again a very difficult procedure, and then place the dental implants. Okay, I'm ranting here. Probably should make another video just about this topic. The bottom line is that you'll get your implants and your teeth, but they might look different than what you expected them to look like. Best of luck to you!

[@bechaydapechay9601]

Hi dr John, i just had the implant 2 moths ago! As per my dentist one of the implant is not doing well and he is planning to remove it and implant it again. Can he do that the same day? Or should wait for the bone to heal before re doing the implant? Thank you very much

[@johnjazayeri]

Hi. Ok, so you had 2 dental implants, one which took and one that didn’t. Typically, it’s best to remove the failing implant, graft the area and let it heal for several months, then redo the implant. Redoing the implant same day would require removing the failed implant and placing a larger, new implant that goes in further into the bone (at least 1 MM wider and 2 mm deeper). Which option do I prefer? The first one typically. Especially on younger folks. I know it can be frustrating having to wait an extra 6 months, but it’s worth it. Better long term prognosis. Hope that answers your question and best of luck.

[@jenniebaez6947]

Thank you for this information. I had implants done 6 months ago and have felt tightness and headaches from the tightness. Is this normal after six months? I am getting fitted for for dentures. I also have jaw pain. I m hoping this discomfort goes away once i get the dentures. I am not sure if this is normal.

[@johnjazayeri]

Hi Jennie. The "tightness" from dental implant surgery is caused by the torque/pressure that the implant screw places on the jawbone. The tightness can be quite painful and usually last for several weeks or months. However, it should improve over time. 6 months seems like a long time, you might want to discuss it with your dentist. The other reason you could be experiencing headaches is that you don't have a proper bite relationship. If you have no more teeth, or no back teeth at least, then this stresses your TMJ and causes pain and headaches. A well fitting denture can help reduce this pain over time, although it may not resolve 100%. Check out my video on TMJ pain to see if you can figure out more about the source of your pain or how to resolve it: kzbin.info/www/bejne/iqTPfHx-lJp0ndE Good luck with your treatment!

[@janereed4113]

Thank you for this video! The Oral surgeon I went to hardly explained anything. After watching your video I scheduled another appointment with him to get more information before he does the extraction and bone implant. He also wants me to get a retainer to wear while the bone graft is healing. Is that necessary?

[@johnjazayeri]

Hi Jane. I'm not sure exactly what the retainer is for. I usually make a retainer after a tooth extraction when the patient is removing a front tooth and they want to have a temporary tooth during the healing period. The other implication of a retainer is to keep the remaining teeth from shifting and drifting during the healing process.

[@et1097]

Thanks

[@annamartino5681]

Dear Doctor, thank you very much for this video detailing the steps to build the implant. Is there anything that can be done to avoid Step 4 Implant Exposure Surgery and instead make it exposed originally during the Placement Stage 3 and perhaps cover it somehow (on the one side back molars?

[@johnjazayeri]

Hi Anna. Thank you for watching my video and paying attention! I'll try to answer your question without getting too technical: Yes, there is a way to avoid performing second stage surgery, aka, surgery to expose the buried implants. If your dentist places the implants, and instead of putting a small "cover screw" on top of the implant fixture, he or she places a large "healing cap", then you will NOT require second stage surgery. In other words, if your dentist places a large cover that sticks above the gums, then the implant(s) is already exposed and it won't require a second procedure to expose the implant. I bet you're wondering "why don't dentist just do this all the time to avoid performing an additional surgery?" The reason is that most of the times the implant must be buried underneath the gum tissue to heal properly. For example, if there is significant bone grafting, extensive gum procedure, soft jawbone, etc. then the implants must get buried underneath the gums to properly heal (or they could fail). Of course, if your implant doesn't require any grafting and you have hard enough jawbone, then the implant can be placed with a large healing cap above the gumline to avoid the need for second stage surgery. You must be very careful if your implant is placed above the gumline. No chewing hard food, no playing with your tongue, and no electric toothbrushing for several weeks. Sorry, I know I said I won't get too technical, but I just couldn't resist! I hope this helped answer your question, and best of luck with your implant treatment.

[@lorieharrington7693]

After second stage surgery will my flipper still fit? Will there ever be a period of time when I will have to be toothless

[@johnjazayeri]

Hi Lorie. Great question. To recap, when your dentist performs second-stage surgery, the implants are now exposed. You will see large circular metal objects that stick above the gumlines. These are known as healing caps and they allow your gum tissue to heal before the final crowns. Your wondering if you can continue wearing your flipper (temporary denture) after the implants are exposed. Yes, you can, if your dentist puts the time into it. There are two basic options, which are: 1. Put holes in your flipper: This is the easier solution. Your flipper fit usually alters once the implants are exposed. Your dentist can poke a few holes in the flipper, corresponding to where your implants are located, and you can continue using the flipper for the next few weeks/months while he or she makes your permanent teeth. I do this by pouring putty, inserting the flipper, identifying the implant locations, and poking holes in the flipper. You can wear your flipper on top of the implants without any interference. I favor this technique when I'm replacing full arch cases. 2. Make a fixed temporary on top of abutments: The other technique involves making fixed temporary teeth. This does take longer and there might be a fee for it. Your dentist performs second-stage surgery. Then, he or she will place abutments in place of the healing caps. Afterward, your dentist will use crown and bridge material to make a temporary set of teeth on top of these abutments. This technique works best for replacing just a few teeth. I hope this helps. I didn't get too technical here, but I tried to explain the process in simple terms so that you can understand. How many teeth is your flipper replacing? Good luck!

[@lorieharrington7693]

@@johnjazayeri Thankyou so much. I’m just having one tooth replaced! Such a long process….it will be great when it’s all done.

[@bibhuti66]

Hi dr John, I am 32 and I am from India. I have to go through a full mouth implant, and I have a good amount of bone loss, so it is a complicated case. can you pleas help me?

[@johnjazayeri]

Hi. Sure! Post your Panoramic X-rays in the comments and I’ll give you a treatment plan. Share your medical issues, smoking history, etc. if you’d like a more accurate diagnosis .

[@Blooding]

The dentists gave me an option to go under or get numb in the area. Which is better? They want to extract, bone graft and implant the same day. Thanks for all you do. Wish you were in Texas. haha

[@johnjazayeri]

Hi there. You can learn more about sedation (going to sleep) by checking out my video" kzbin.info/www/bejne/fH3HgGqYe9CkqNU. Personally, for one extraction and dental implant, I usually don't advise full sedation. It's a bit too much in my opinion. Unless it's a super complex case or you're deadly afraid of the dentist. If you have had a tooth removed while awake, you should also be able to handle this treatment while awake. If anything, I advise using Nitrous Oxide gas to calm your nerves and take the edge off. Good luck and let me know how your surgery goes. Also, I have a video on same-day tooth extraction and implant placement for those who want to learn more about this process: kzbin.info/www/bejne/i6W0YmammbiHb7c

[@Blooding]

@@johnjazayeri Thanks your the best!

[@solsantana4740]

Is it natural de have your face swollen on the site on the implante, 2 months after the post was placed?

[@inkbold8511]

No

[@leonorsilva6307]

I had extraction and had implant placement right away, is that normal? 😨

[@johnjazayeri]

Hi Leonor. Yes, this is normal and common. The process is known as immediate implant placement. In fact, I do this all the time in my own practice. It saves me time and saves the patient from additional surgery. I have a video that explains exactly how this process works and when you qualify for immediate placement. Check it out: kzbin.info/www/bejne/i6W0YmammbiHb7c

[@geraldinemcardle2418]

I don’t understand this if I’m getting all my bottom teeth out u saying I wait till it heals . My dentist says different

[@kosland2000]

I damaged my front 2 teeth in a sledding accident. We tried posts for decades but they always get loose. So I'm doing the implants. It will be a 4 tooth bridge. I'm confused how it stays on the abutment. If it's cemented how does it not get loose

[@johnjazayeri]

Hi there. Ok, you also got me confused. You lost/are losing your two front teeth, but you are getting a 4 tooth bridge? It sounds to me like you're getting a bridge, not dental implants. Dental implants would require two implants to replace two teeth, not four. You might want to do more research to make sure you understands what treatment you are receiving.

[@barryfitzgerald3839]

Can you have MRI after Titanium implant ?

[@johnjazayeri]

Hi Barry. The titanium alloy used in dental implants does not have much of a magnetic force, so it does not interfere with MRI. There may be a small amount of metal alloys used in the abutment and crown itself. Typically, these metals do not have much of a magnetic force and do not interfere with MRI. If you go with ceramic crowns, you're generally safer.

[@PAOLINAG]

Can my existing crowns be used for my new implants?

[@johnjazayeri]

Hi Paolina. Lol, funny you ask that question since I've had several patients ask me this before. Unfortunately, no, you can not use a tooth crown to fit your implant. Crowns require very precise fit. The structure of the tooth and dental implant are totally different. There is no way that a crown that fits your tooth would also fit your implant. Think about false teeth, dentures. Can you wear someone else's denture? No way, they have different jawbone, gums, tooth height, etc. The same can be said for crowns. Hope that helps, and good luck with your implant treatment!

[@summerwmina]

Can you place one implant for two adjacent teeth ? Is this down only for front teeth or can it be done on molars?

[@johnjazayeri]

Correct. You can place two crowns on a single implant post for missing front teeth. You can NOT do this for the molar teeth. The reason comes down to the strength of the implant compared to the size of the tooth crown itself. Front teeth are not that wide, plus they don't receive as much forces during chewing. As a result, you can place two crowns on one implant screw to save time and money. On the other hand, molar teeth are very large and they are under far more stress since these are your primary chewing teeth. As a result, you almost always have to place one screw to support one crown when it comes to the molar teeth.

[@geraldinemcardle2418]

What my dentist is putting a crown on the same day

[@solsantana4740]

I put the implant in about over 2 months ago and my face still swollen, is that normal??

[@johnjazayeri]

Hi Sol. It's not normal to be swollen 2 months after a dental implant. I would say a few weeks to one month is normal. However, two months is too long. Have you gone back to your dentist? There is a chance the implant is infected, or it might not be integrating with your jawbone (in which case it needs to be removed). Of course, that is not always the case. Sometimes the gum tissue on top of the implant remains slightly swollen for the duration of the healing process. Either way, I would recommend scheduling a visit to your dentist to make sure the swelling is nothing serious.

[@solsantana4740]

Hi John, I did go back. He said the gum had a little infection and prescribed an antibiotic. The gum was red and sensitive. But from the outside, im able to touch and massage the area without any pain. I was wondering if the post (base) is to thick for my jaw none. One of my sister have 6 implant and her face still the same as before, while mine it seams I have a tooth problem.

[@geraldinemcardle2418]

I see no link above

[@SandiFischer]

I have a question, I have to get a bone graft using my hip bone first, and they are going to cut under my jaw not from inside 😭 so I am guessing I will have to wait to have my implants placed till this bone fuses because they say my lower jaw bone is so thin right now if I sneeze wrong it will break so they cannot put an implant because the bone would break, so roughly how long will it take for this kind of bone graft to heal enough to put the implants in? I am praying I can still wear my dentures during this process

[@johnjazayeri]

Hi Sandi. It sounds like you're having an autogenous bone graft procedure. This is where they take bone from one region of your body (hips in your case) and transplant it into another region (lower jaw). This treatment is reserved for the most aggressive bone loss situations, which seems about right regarding your situation. A treatment like this usually takes 6 to 9 months, sometimes even closer to a year, in order for the donor bone to heal at its new site. You might be able to use your dentures in the meantime, but there are situations where your denture won't fit or your dentist instructs you not to use your denture for several weeks or months after the surgery. It all depends. Good luck with your surgery and let us know how you heal. Oh, and be sure to stock up on lost of lots of smoothies for your recovery!

[@SandiFischer]

@@johnjazayeri oh my gosh I had no idea it would take that long, so they would wait to do the implants until after this period?

[@johnjazayeri]

Correct. First, the bone graft must heal, then the implants can be placed. Each process takes 6 to 9 months, so you’re on a 2 year long journey here. Be patient and discuss a good temporary option to use during the healing process.

[@geraldinemcardle2418]

I wasn’t told if I get my tooth out I need bone

[@TeeTee-zm2re]

Is bone graft placed immediately after tooth extraction? I've been told not.

[@johnjazayeri]

Hi Tee Tee. You have been told incorrectly. Bone graft is typically placed at the same time as the tooth is removed. Of course, it can also be added in the future. However, it’s best to perform bone graft at the time of tooth removal. First off, it’s easier, and you don’t have to get numb twice. Secondly, placing a bone grafting at the time of tooth removal to take advantage of the bleeding that occurs for better healing. I recommend that you always get a bone graft at the time of tooth removal, especially if you are planning on placing a dental implant in the future.

[@TeeTee-zm2re]

@@johnjazayeri the tooth I'm having removed has suffered from periodontal disease and is slightly loose and dropped. Does immediate bone grafting after extraction still apply? Btw it's a upper front tooth. Thank you

[@gaurab197]

@@johnjazayeri can bone graft be done in socket if implant is taken out post operative after 20 days due to infection in apical area of the implant. Will the infection not get into bone graft?

[@thehardlife5588]

Do you always need a bone graft in particular upper left premolars

[@johnjazayeri]

Hi again. So as you know, bone grafts help preserve additional jawbone after tooth removal surgery. Having more jawbone is very helpful should you decide to place dental implants in the future. Bone grafts also protect your neighboring teeth from becoming loose, developing sensitivity, etc. Your question is specifically about the upper premolars (left or right is exactly the same). Upper premolars, teeth #4, 5, 12 and 13, are located underneath the sinus membrane. This means that the sinus has a good chance of dropping down and causing complications during implant placement. As a result, bone grafts are very helpful for the upper back teeth. This is compounded by the fact that the jawbone in this region is the softest, thus the worse for placing dental implants. Many patients who don't get a proper bone graft after extraction of their upper back teeth find themselves unable to receive dental implants in the future. Others face having to get difficult and expensive sinus surgeries (sinus lift or lateral wall sinus graft) which have long recovery times, serious pain, and risk of sinus infections. Therefore, if you're plan is to get dental implants, whether it's in 6 months, 6 years, or 20 years, then I suggest that you perform bone grafts after removing your upper back teeth, both for molars and bicupids. I have another video that gets into details regarding bone grafting, if you have time to watch it: kzbin.info/www/bejne/hZupnJWMqK-Nlc0.

[@thehardlife5588]

@@johnjazayeri i dont think my sinus has dropped, evidence from my latest 2d xray, but the buccal bone has caved in abit, this is because i assume the way the extraction was done, the surgeon just slashed my gums and pulled it out in 30 seconds

[@ferdsbisco3752]

Thank you again. I had another question - I have the abutment in place for almost a month for molars - one top left, one top right and another bottom right. Will I be able to start to chew on them for soft food items? Can I still eat chips but as long as I dont bite on them with the implants?

[@johnjazayeri]

Hi Freds. Generally speaking, you can start chewing on your implant posts (screws) about a month after the screw are placed. Sure, there are cases where you can start chewing on within a few days, few weeks, etc. But I'd say it's a safe bet to start chewing on your implant posts a month after the screws are placed. Abutments are generally placed AFTER the screw has healed properly and integrated with the jawbone, therefore it's safe to chew on implants that already have abutments on top of them (unless otherwise specified by your dentist).

[@ferdsbisco3752]

@@johnjazayeri Thanks again for the information. I must have mis-stated but they are just screws in place with the cover and will have the abutments in about 3 more months.

[@stephaniecoffia8619]

O I also had all my teeth pulled out the same day

[@summerwmina]

Can you place an implant with infection?

[@johnjazayeri]

Great question! The answer varies depending on the scenario, so let me break it down: 1. Infection ONLY in the tooth and not in the jawbone: If the infection is restricted to the tooth, then there are no concerns regarding the dental implant. This means that you can have a throbbing toothache, but since the infection is not in the jawbone, you can remove the tooth and place the implant right away. This is why we often times take a CBCT to evaluate the jawbone to see how widespread the infection is. 2. Small infection in the jawbone: Once the infection has reached the jawbone, you shouldn't place the implant right away. These teeth need to be removed, and you need to place a bone graft into the socket. A few months later, the bone grafting will heal, and you can proceed with the dental implant as planned. 3. Massive infection in the jawbone: These are the toughest cases, and sometimes you can't place a dental implant after a massive infection. You definitely need to graft the area and wait several months. Sometimes you need more than one grafting procedure. Massive infections eat away at your jawbone, and make it tough for the bone graft to take. These cases may take a year or two, and may require multiple grafting procedures before the area is ready for implant.

[@williamowen3449]

Mines took 3hrs

[@soundman6645]

Good information btw Are you related to "Con The Fruiterer", there are similarities in the presentation. :) Check his vids on youtube .. :) :)