Periodontal Disease - 70% bone loss

[dmiller64152]

After years of neglect, I finally went to the dentist and he found 70% bone loss plus s 7 mm pockets in #5 and #7. (Most of the other teeth were between 2 - 4 mm with no bone loss) I was referred to a periodontist who has recommended bone grafts for those two teeth in addition to scaling/planing. Fortunately I have good dental insurance that will cover most of this, but is there any chance of saving these teeth? Both have some mobility. My insurance also covers part of the cost of implants and the #7 tooth is already protruding and twisted -- would I be better off just having it extracted and then having an implant after the bone graft? Last question -- if I have the tooth extracted, is there any period of time that I would have to go without a temporary tooth/plate in that area?

[Gellia]

You sound just like me.  I had 70% bone loss in one of my front top teeth and the laterals on each side had started to twist.  I found the best thing for me was to just go ahead and get four extractions and four implants, which is what I did.  

I couldn't have been happier with the final results.  While the implants were healing I used a metal removable partial so that I could use it when I ate.  As a matter of fact, I even slept with it in!  No one, the whole time the implants were integrating, saw me without my teeth.  I was very happy with the MRP.  They do have "flippers" that can be used with single implants.  

70% bone loss is quite a bit.  It's my understanding that if the tooth can wiggle from side to side (they all can move slightly front to back) it's pretty much a gonner.

Maybe you should ask your dentist what the chances are of saving a tooth that can already wiggle that much and has that much bone loss.  My periodontist told me there was no saving mine (mine hardly wiggled at all)  and that it was best to just go ahead and get all four as the two that had twisted indicated substantial bone loss there, too.  This was all confirmed by the xrays I had.

I'm really happy that I had the implants.  

Hope this helps some.
My very best to you,
Gellia

[dmiller64152]

Thanks for your quick response. I'm probably more worried about the aesthetics than actually saving my teeth. This whole thing started because I am finally in a financial position to get veneers, but of course that can't be done until I have my perio issues under control, and possibly never to the teeth that are going bad. I'm going to ask about just having the two bad teeth extracted because it seems like that would produce the quickest results, and then having another six veneered. It will be great to have decent looking teeth after all these years of hiding my smile.

[Gellia]

I love my implants.  The one thing about bone loss is that your gum cannot attach unless there is bone below it.  If you have a gummy smile good aesthetics can be a problem.  There is always a gum graft if it is needed, though.  

Your idea sounds great.  I would caution you on one thing, though.  In order for implants to be successful, they need healthy teeth and bone on each side of them.  If your teeth are starting to twist, it usually indicates sufficient bone loss to allow them to do so.  Make sure your veneered teeth are healthy enough to butt up against your implants.  

An implant process is still a long one before the final results are seen.  Do make plans to have something to fill in the spaces while they heal.  Cheapest, I believe, is a "flipper".
My understanding is that they are difficult to eat with them in place.  I went with the more expensive metal removable partial because it was my front teeth and the healing process was going to be 6 - 8 months.  

The final result was worth it for me.  If I can help you further let me know and good luck in whatever you and your dentist decide.  Please let us know how you do.  

Best to you,
Gellia,