Are implants are more predictable than teeth?

 

Don't get me wrong... I think having the ability to treatment plan implant restorations has added a great tool to most dentist's tool box, but sometimes salvageable teeth are extracted to facilitate implant placement and a definitive full arch fixed restoration.  I myself do this when the bone is needed to place an implant that will serve as an abutment for a multi implant treatment plan. Sometimes teeth do get in the way. 

That being said, there seems to be an increasing tendency for dentists to advocate the removal of all remaining teeth to fabricate a "hybrid" full arch implant restoration. There is a nasty joke going around about all on 4 implant cases ... they are great unless one of the implants doesn't take or last long and then the entire case can be considered a failure since there is no such thing as an all on three case.

Also many patients are encouraged to have expensive full arch implant treatment cases without empasizing the need for the cleansability of their implant restorations and the importance of adequate patient home care and frequent cleanings at their dentist. Implants can develop peri implantitis , a condition similar to periodontal disease. This is characterized by progressive bone loss around an existing implant.

Sometimes its better to kick the can down the road for many patients, even if it means they will have a partial or full denture made. Maxillary full dentures can be very satisfactory if made well and can be highly esthetic and their fabrication rarely breaks the bank or requires a patient to take out a second mortgage on their house.

All on 4 cases can be wonderful but they are expensive and if they don't stand the test of time, most of the patients will either end up wearing a full denture or spending more money in a second go around since it will be necessary to have and additional implant(s) placed and a new temporary and permanent bridge fabricated.