Go to another doctor and get a second opinion.  Perhaps a 3rd.  Gadgets and
gizmos don't mean a thing in certain instances.

Never heard of temporary implants but that doesn't mean much.  The problem
with implants in growing children is the implants don't move while the rest
of the bone continues to grow.  I'd get a 2nd opinion myself.

jwn dds

Sounds reasonable, but just what are 'temporary implants'
and how are they removed ?
At 13 suspect all the permanent teeth are erupted.

Why not go with permanent implants right now ?

Try "Paging Dr. King" in this group, he is OMFS and
he usually answers quickly.

--
W_B

wubbabubbazG@RBAGEyahoo.com
Take out the G'RBAGE

I hate ER physicians when it comes to the mouth.  Teeth need to go back in
in less than an hour to have any hope of success.  Referring you to the OMFS
the next day is NOT acceptable.  I think you would want something in there
to preserve bone.

The only purpose that the bone around the teeth serve is to maintain
the teeth.  once the teeth are lost this bone starts to resorb
(disappear).  what everyone is worried about is that by the time he is
ready for implants, there may not be enough bone available to hold the
implants or the implants will need to be so long that if he smiles and
shows all of his teeth (usually so in young people) you will see the
implants.  doing real implants now is generally not considered a real
option because they "get left behind" as growth continues.  The
tallker your son grows, the greater the heigh discrepancy between the
implant sire and the rest of the jaw.  real implants are hard to
remove.  would they be the best choice at this point?  who knows?

unfortunately the choice are not great.  I think most of us here have
not heard of temporary implants.  they could be the narrow (1.8 mm
miniscrews) as discussed by AV but I don't know for sure.  whether
they would serve to stabilize the bone is another question I'm not
certain I can answer.

the choices as I see it are as follows:

1. best choice but almost never done in the US - transplant two max
second bicuspids into the space where the front teeth are.  these will
be replacement teeth and will act as real teeth.  they will maintain
the bone and, in fact, can be restored to look like front teeth.  the
reports out of Scandanavia and there are many is that this is 90+%
successful and tend to last indefinitely.  there are surgeons in the
US who do this but it is far less comoon than in Scandanavia.
Orthodontic treatment would be necessary to close the spaces created
by taking the max second bis but this is usually a minor issue

2. the bone grafting done by the surgeon is good to protect whatever
bone remains.  if resorption continues he may need additional grafts
later but the problem for the implants is that you generally can't do
vertical grafts but only horizontal.  Most likely he will need
vertical bone not just horizontal.  there is a surgeon in San
Francisco who is working on mini distraction osteogenisis procedures
in which he would be able to "grow" bone vertically but this is fairly
rare although logically it makes sense.

3. since bone is the issue, anything else is just cosmetics like a
partial denture.  that will replace his front teeth for cosmetic
reasons but the bone underneath will still resorb.

4. there are not many great choices although hopefully by the time he
is ready for the implants procedures will be available for bone
regeneration or the distraction osteogenisis will be more widely
available.

5. check with your medical insurance company.  in the old days before
managed care, trauma was a covered expense for one year after the
injury.  you might be able to extend that coverage period if you
talked with a lawyer.  depending on what is done, you could be looking
at $25,000 anyway between now and age 20.

if this were my son I would find the closest major pediatric dentistry
training program and see them immediately.  UNC, IOWA have great pedo
dental programs and tehy should be able to advise best.  there are
others.

hope this helps

charles j ruff
specialist in orthodontics
board certified in orthodontics