Patients frequently defer replacement of a missing posterior tooth on the basis that it is not visible and not painful. The costs of that decision are real, but they accrue slowly and are therefore easy to discount.
Bone loss
Alveolar bone requires functional loading to maintain its volume. Following extraction, resorption begins immediately and is most rapid during the first six to twelve months.
The practical consequence is that an implant placed promptly frequently requires no grafting, while the same site treated five years later frequently does. The deferral therefore converts a straightforward case into a more complex and more expensive one.
Drifting and overeruption
Adjacent teeth migrate into the edentulous space and the opposing tooth erupts toward it. Both processes are slow and neither is symptomatic.
Once they have occurred, restoring the space may require orthodontic realignment or reduction of the overerupted tooth, adding treatment that would not otherwise have been necessary.
Occlusal consequences
Loss of posterior support transfers load to the remaining teeth, particularly the anterior dentition, which is not structurally adapted to it. Wear, fracture and migration of anterior teeth in patients with unreplaced posterior units is a well-recognised pattern.
The arithmetic
A single implant placed promptly is among the more predictable procedures in dentistry. The same site addressed a decade later may involve grafting, orthodontic preparation and treatment of adjacent teeth, at several times the cost.
The decision to defer treatment is legitimate, but it should be taken with knowledge of what it costs, which is rarely nothing and rarely stays constant.
For an individual assessment of your case, you can request a consultation at our Bogotá practice.
