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Backtooth implant or not?


THAIPHUKET

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The long answer....at this website

https://pasadenaperiodontics.com/bone-loss-treatment/#:~:text=The most common cause of,(reabsorbs) into the body.

What causes bone loss?
Bone loss is a common consequence of loss of teeth and chronic periodontitis. In the case of periodontitis, the bacteria gradually eats away at the underlying jawbone and at the periodontal ligaments that connect the tooth to the bone.

The most common cause of bone loss is tooth loss left unreplaced, especially multiple teeth. Jawbone is preserved through the pressure and stimulus of chewing. When that is removed through tooth loss, the bone “resorbs” (reabsorbs) into the body. In the first year after tooth extraction 25% of bone is lost, and this bone loss continues on.

Bone loss

This bone loss occurs in the bone surrounding and supporting the tooth, known as alveolar bone. Alveolar bone forms the ridges in which the teeth are embedded. These ridges atrophy both vertically and horizontally.

Replacing teeth with full or partial dentures doesn’t solve the problem as the dentures exert a very small amount of chewing pressure on the bone compared to natural teeth, as low as 10% or less.

Removal of the molars in the upper jaw can cause additional resorption of the bone due to expansion of the sinus cavity. With no teeth in place, the air pressure in the sinus cavity can cause resorption of the bone lining the sinuses.

 
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That's very helpful, Seth.

To get a risk assessment, I should ask my very good dentist, who doesn't do Implants.

He would to a denture but said this may not be very appealing either, tongue irritation, cleaning...

How did you proceed?

Edited by THAIPHUKET
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27 minutes ago, TC17 said:

Would a bridge stop the bone loss?   

No.

 

A Bridge is to fill the gap and is supported on two adjacent teeth which have to be prepared (so in theory damaging the two adjacent teeth if they are in good condition) to support the bridge.

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38 minutes ago, THAIPHUKET said:

How did you proceed?

Actually still stuck between covid and travelling to get an implant  done where I want to...

the dental flipper I use keep the teeth from shifting too much but ultimately the replacement would be the ideal solution.

 

Going to step back now and wait for someone who had it done to step up to the plate with more answers.......

Edited by Seth1a2a
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37 minutes ago, Seth1a2a said:

Actually still stuck between covid and travelling to get an implant  done where I want to...

the dental flipper I use keep the teeth from shifting too much but ultimately the replacement would be the ideal solution.

 

Going to step back now and wait for someone who had it done to step up to the plate with more answers.......

I had a rear lower molar implanted a fee months ago. The tooth was bad under the crown. There was some tooth loss but not enough to need a graft. It took ages to do due to covid. The benefit is that I can chew on that side now. My crown is also a removable crown so it's easily adjustable (which the dentist did on my followup visit). 

But its been fine since. It takes a week or so for it to feel normal. It feels a little different than normal teeth as its not flexible, as there is no ligament around the implant, unlike a normal tooth. Cost about 65K baht. Note: an extraction is more uncomfortable than getting the bone drilled. Hardly noticed it. 

Edited by DavisH
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9 hours ago, THAIPHUKET said:

To implant or not?

Who got several implants and had no problems?

Like to share my experience with you. I have 2 extractions and 5 implants last year from Jan to Jun 2020. Goes weekly for the procedures. No pain at all, did not even need to take the Pain killer - Ibuprofen. Total cost just under B300k.

Done in Bangkok. I am 69 years old. ????

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Thank you Siam read, in a side note I'm about your age, which can be important for that procedure.

1. Your dentist seems to be top notch.

2 it may be worthwhile to have my case by him too.

Once I'm closer to a decision I will be in touch, if that's ok with you.

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2 hours ago, SiamRead said:

Like to share my experience with you. I have 2 extractions and 5 implants last year from Jan to Jun 2020. Goes weekly for the procedures. No pain at all, did not even need to take the Pain killer - Ibuprofen. Total cost just under B300k.

Done in Bangkok. I am 69 years old. ????

Can you just confirm 300K?? I have had, over the last 10 years, 3 various back teeth pulled, root canals and implants fitted. The cost has not varied too much. Around 10k each time. All still in tact by the way.

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I got four implants 19 years ago; no problems since and absolutely no regrets; money well spent.

I lost three lower back teeth in each side due to medicine I needed back then. Because of bone loss, the dentist could only give me two implants on each side.

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48 minutes ago, farang51 said:

Because of bone loss, the dentist could only give me two implants on each side.

I was told by my dentist that if there is significant bone loss then first comes a bone graft.

 

I am about to start on a whole mouth rehab deal, several sessions, so would be curious about experiences with bone grafts and implants.

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18 hours ago, THAIPHUKET said:

Thank you Siam read, in a side note I'm about your age, which can be important for that procedure.

1. Your dentist seems to be top notch.

2 it may be worthwhile to have my case by him too.

Once I'm closer to a decision I will be in touch, if that's ok with you.

No problem. Glad to help. My dentist is a Professor at Mahidol University. Done at a reputable Clinic. Just PM me when you need more info. 

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18 hours ago, Catkiwi said:

Can you just confirm 300K?? I have had, over the last 10 years, 3 various back teeth pulled, root canals and implants fitted. The cost has not varied too much. Around 10k each time. All still in tact by the way.

Yes. I confirmed all together cost a total of just under B300k. It was done in early 2020.

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4 hours ago, Why Me said:

Hmm, I got a quote for a single implant from Bangkok Smile ranging from 39,000 - 80,000 depending on brand (Neo Bio Tech, Dentium, Straumann, ...).  Which agrees with DavisH and SiamRead's figures for their jobs. 10k seems impossibly low.

 

10k for an implant is indeed impossibly low.

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I had two implants put in last July,  The cost was 110,000 for both.  I went to several well known places to  get assessments, Bangkok Smile, Bangkok International Dental Hospital  (BIDH), and BFC Dental in Bangna.  BIDH is the newer sister hospital to BIDC, which is popular among foreigners.  They offered me a package of two immediate load implants and zirconium crowns for 139,000.  However, when I went to have the teeth extracted, the implantologist told me that I would actually need a major bone graft that would cost 50,000 per tooth and take 7 months to heal.  I passed on that one.

 

I ended up going with S Clinc Sathorn, which is over on Suan Plu Soi 8, and was previously recommended on this forum.  The dentist, Dr, Pokpong, studied at UCLA and has been doing implants for more than ten years.  The other three places I went to had all said I would need a bone graft but he said it wasn't necessary as long as I had the implant put in before the bone was reabsorbed.  Apparently, over half of the bone mass is reabsorbed during the first three months after a tooth is pulled, so after that a bone graft may be required.

 

He offers Osstem, which cost 55,000, and Nobel Biocare, which was around 75,000, if I remember correctly.  Each of the other places had strongly recommended Straumann, which is the  most expensive implant, but Dr. Pokpong explained that the patents on implant technology has already expired so now all of them were basically the same and recommended Osstem.

 

He has a computer program that monitors the procedure, which took maybe twenty minutes or so per tooth.  I received pain medicine so I didn't feel anything nor was there any pain afterwards.  He gave me pain medicine to  take home  just in case but I didn't have to take it.  He didn't do a CT scan though.  He said it wasn't necessary.

 

So far I haven't had any problems.  I can eat pretty much anything with no problem but it's not a real tooth and the implant doesn't move, so there is a difference in the way it feels but it's still a lot better than being toothless.

 

Based on my experience, I would say avoid the big, famous places that target foreigners and find a privately owned clinic with a dentist who trained abroad.   Just about every clinic in Bangkok offers implants but many of them hire an outside doctor who receives a commission, so there is an incentive to offer unnecessary procedures or higher cost implants.  So if you find a clinic where the dentist does the implants himself, it will reduce your cost and you'll probably get better aftercare service as well.

 

My girlfriend is now going Dr. Pokpong for Invisilign, which is another one of his specialties.

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4 hours ago, Cleareye said:

Each of the other places had strongly recommended Straumann, which is the  most expensive implant, but Dr. Pokpong explained that the patents on implant technology has already expired so now all of them were basically the same and recommended Osstem.

Great info, thanks. I am going for multiple crowns at Bangkok Smile and the prosthodontist thinks I might need a couple of implants (and possibly bone grafts). They quoted me a range of prices for implants as mentioned in my earlier post

On 2/8/2021 at 5:58 PM, Why Me said:

single implant from Bangkok Smile ranging from 39,000 - 80,000 depending on brand (Neo Bio Tech, Dentium, Straumann, ...). 

but haven't (as yet) recommended a particular one. But from what Dr. Pakpong told you there's no need to go for a high-end name.

 

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This thread has made me curious.  I lost the 2 upper, rear-most molars on each side more than 15 years ago, lowers seem ok.

Considering it's been 15 years, would I be an unlikely candidate for molar implants?  Would I probably require bone grafts?  What is involved in bone grafts?

 

Honestly, I never really considered molar replacement until reading this thread.  I should add that I'm in my mid-70s.

Edited by dddave
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Althoughdone in my homeland, around 2008 & 2010 I received 4 molar implants in total; 2 in the left jaw and two in the right jaw. For the right jaw some artificial bone had to be applied to create a firm base there.

The only "problem" I had was that one screw holding one crown on the implant loosened twice since. The second time that happened, I retrieved the implant type/make and the torque with which it should be tightened from the homeland implantologist, and got it re-tightened in Thailand 3 years ago. No issues with that eversince.

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3 hours ago, dddave said:

Considering it's been 15 years, would I be an unlikely candidate for molar implants?  Would I probably require bone grafts?  What is involved in bone grafts?

I think you would need to see a prosthodontist for an opinion about implanting. Re bone graft, a CT scan (3d scan) will say the extent of bone loss and if grafting needed is what I was told. Here's a bunch of  info:

https://dentaldepot.net/everything-you-need-to-know-about-bone-grafting-for-dental-implants/

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