Dental Implant in Tight Space: How to Make it Work
Dental implants are a popular solution for people who have lost one or more teeth. They are a permanent replacement that can look and function like natural teeth. However, when it comes to dental implants in tight spaces, it can be a challenge to find a solution that works. A tight space is any area that the bone or space is just barely bigger than the standard implant size. This lack of room makes it tricky to place the implant as there is no wiggle room for error. So how does one go about doing it?
Methods for placing a dental implant into a tight space.
We prefer to not use a guide as it limits what you can see and has some built in errors such as waggle. This is assuming that we are talking about a single dental implant in space that has teeth on both sides. We like to use the teeth as a guide for our drill and be able to see them clearly. We find it is also helpful to do these as immediates as you also have the tooth socket to use as frame of reference.
When do you need to place an implant into a tight space?
This is most common in cases of patients with missing upper laterals. The next most common time is in the lower anterior. Of course there are always exceptions and there can be premolar spaces that are tight and there can also be molar spaces that are tight in the buccal/lingual dimension.
What can you do if there is not enough space?
When there is not enough room for a traditional dental implant, there are a few options to consider. You can make more room but that requires orthodontics or bone grafting and can be tricky to accomplish. Thus, it is cost and time consuming and the results can be unpredictable. You can abort the dental implant and place a Maryland bridge in the area. Another option is a cantilever bridge. A less known option is the spring cantilever bridge, however, if labs will be aware of these and willing to make one. The last option is a removable retainer of some sort.
What about mini dental implants for a tight space?
Mini dental implants are a smaller version of traditional implants that one can use when there is not enough space for a regular implant. They are not as strong and their success rate is not as good as traditional implants but they are acceptable. Some dentists like them and some do not. We prefer to exhaust all other options before going this route.
What are the risks of placing a dental implant into a tight space?
Since there is no wiggle room for error, the implant may not end up in the right spot and can fail. These failures, since there is not as much bone to begin with, often result in no bone being left to try again. One can also inadvertently damage one of the teeth next to the space. This damage can cause things like bone loss, root canals, or even the other tooth being lost. Below is a dental implant on a young healthy patient that went in perfectly, yet still did not take. These are frustrating!
