implant in lower left 2nd molar?

[realnico]

due to a failed filling of all things (my previous dentist's now been struck of the GDC list based on two - one of them mine - cases brought against him) i'm going to lose the lower left second molar, if not now then sometime soon. also due to his poor work the lower left first isn't in great shape although it's not root treated (heavily filled though following his dentistry). all my other teeth are fine though - these are actually my only problems/fillings :-(

my question is, will it be possible and *advisable* to get a dental implant in the lower left second molar? i've seen some very well-known implant dentists for consultations and opinions seem to be split about whether i should have it done. one said that although i can have it done (sufficient bone), it's better and healthier just to leave a second molar, whilst another said that all teeth should always be replaced with implants where possible and firmly advised me to go for an implant.

i don't know who to trust! i guess my question is: assuming there's enough bone, is it generally best to implant a missing LL7 or leave it open? I'm 32 btw and the cost isn't an issue for me for once!!

[prosman]

if you have an opposing tooth then it makes sense, teeth work as a chewing unit i.e. the upper and lower teeth together.
you are also young and the best time to replace the tooth (if you are going to replace it), is shortly after it has been extracted, so i would suggest if you are financially able to have the treatment now then do it, if you don't and you lose another tooth in a few years time you will be glad you made that decision.

[realnico]

thanks so much for that, prosman. i'm just wondering, why did one dentist (a very respected implant dentist, who you would no doubt have heard of) suggest that it's never a good idea to replace second molars?

he told me i *could* have it done, but that it was definitely healthiest not to have it done (btw, i do have the opposing upper tooth). his reply scared me a bit of the surgery, considering his reputation.

thanks for your help

[prosman]

thanks so much for that, prosman. i'm just wondering, why did one dentist (a very respected implant dentist, who you would no doubt have heard of) suggest that it's never a good idea to replace second molars?

he told me i *could* have it done, but that it was definitely healthiest not to have it done (btw, i do have the opposing upper tooth). his reply scared me a bit of the surgery, considering his reputation.

thanks for your help

pm me his name out of interest and I will pm you back.

obviously, without an appointment and xrays it is hard to answer specifics on a case by case basis. but, IMO if you have an opposing tooth and are anatomically suitable to have the 2nd molar replaced then I would generally suggest this

i do agree that there is no need to go back that far if you don't show the space when you smile / laugh etc... if there is no opposing tooth, or if the opposing tooth is being held in place by the remaining back tooth which can happen with the upper back tooth being opposed by the lower first molar, but rarely the other way around.

hope this helps

[davidbloom]

Whilst not wanting to sit on the fence, ultimately the decision will
rest with you. If the lower 2nd molar has a tooth apposing it then I
would say there is merit in replacing it. While not essential, if you do
not replace it then this upper 2nd molar becomes non functional and
there is a chance that the upper tooth will over erupt and cause an
interference (bite problem) with the lower 1st molar. Also if the lower
1st molar is heavily restored it may be better to have a 2nd molar
present to reduce the forces placed on the first molar. Also ideally the
first molar should have a crown or onlay to help reinforce it.

On balance for these reasons I feel it would be beneficial to replace
the 2nd molar

Regards

David Bloom
Past President BACD
Accredited member BACD

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[prosman]

Hi Realnico got any further with your decision?