Dr. Jeffrey Ganeles relates the story of a patient he saw for a second opinion who needs much less dental treatment than she was told by another doctor.
I saw a patient recently for a second opinion, a 37-year-old woman who had an upper molar removed in another office. The original surgeon she saw had this crude drawing on an x-ray and told her she needed to have a sinus lift, which is a procedure that is done to create more bone in the upper jaw in order to place a dental implant.
She did not like that opinion for a variety of reasons. First, she really did not want someone doing a procedure on her sinuses. It may be a safe procedure but it is not one that anyone would volunteer for unless it is really necessary. She is also a vegetarian, and the surgeon was talking to her about using a cow derived bone to put into her sinus. She said she has never had meat products, so she certainly did not want to have cow derived material in her mouth.
She came into see me and we were able to take a scan, which is a 3D x-ray of that area. The other surgeon was only looking at a two dimensional x-ray, so he really did not have a full understanding of the available bone. It turns out that she did not need a sinus lift, so we did not have to have the conversation about cow products or additional surgical procedures. She is scheduled to have an implant placed soon in a relatively simple, straightforward fashion.
The other interesting part of this consultation was that the patient did not have a lot of bone in this area. However, I knew that there was enough bone based on my experience, because I have dealt with short implants for a long time, and if you can use a short implant then you typically need less bone to hold that implant in place.
Many surgeons are not comfortable with short implants because they have not dealt with them over the years and they are also not familiar with the current information on short implants. I happen to be very much on top of the latest scientific information on short implants because I gave a lecture in Colorado recently, and I know with certainty that the success rate of short implants is equivalent to that of long implants.
There is an old prejudice that persists among many surgeons that you need to have really long implants to be successful. I know that this thinking is not valid, so I was able to tell this patient with confidence that a short implant is going to work very well. The patient is 37 now, and when she is 67 that implant will still be there and it will still be fine.
Dr. Jeffrey Ganeles
South Florida Center for Periodontics and Implant Dentistry
Boca Raton, FL
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