At what age is it best to place implants in children and how do you determine the growth is over?

Wed, 01/20/2010 - 22:38 — leopold

I have patient 15 years old patient,who complain in gum pain (Fistula is in the furaction and is nonrestorable).
Tooth #19 had a RCT done couple years ago, and now its failed and needs and extraction. On PA x-ray there is a 5-6 mm cyst on mesial root, distal 3-4 mm, and furcation is involvment, and tooth hopeless, and needs to be extracted.
When do you think best time to place implants in children? How do you know when a childs growth is complete and safe to place implants.
thank you.

Comments

Fri, 01/22/2010 - 12:17 — Dr. X

Age for Implant placement differs for a girl or boy

In general the rule I have seen is 18 for a girl and 17 for a boy. You can also do a scan to see if growth is complete. Hope that helps.

Sat, 01/23/2010 - 10:09 — mosalama

Implants in Adolescent Patients?

As both a trained orthodontist and periodontist that performs implants this question is very critical to me and should be to all on this forum.
The best research on this subject can be found by Cronin and coworkers in JOMI back in the late 90's.
Basically, 16 in girls and 18 in boys is an average estimate taken from the literature but this is just an AVERAGE.
How do we know about growth in the ortho literature;
1. A Hand-Wrist film to see complete "capping" cortication of the carpal and metacarpal bones.
2.A series of superimposed Lateral Cephalometric films.
3. Asking the patient about changes in hat size or shoe size in the past year?

In the end, it's a best guess. Having seen latent growth, especially in Class 3, or Vertical Maxillary Excess "Gummy Smile" Skeletal patients, I prefer to wait past the age of 21 or more.
This is a problem that does exist more than we hear about.
Hope this information helps.
Dr. S

Sat, 01/23/2010 - 13:35 — Smith

Implant placement minimum age requirement

I agree with Dr. Salama. Consult with physician to get some growth films. I know a guy who placed an implant in a female at age 16. Everything was fine until she returned 6 years later and sued for malpractice. She continued to grow and the implant remained put. You can picture in your head what the final outcome looked like. Remember, as Salama said, those recommendations are AVERAGES! There is a standard deviation to the average.

Tue, 01/26/2010 - 09:51 — leopold

appropriate treatment plan

Thanks everyone for answers.
So appropriate treatment plan will be extraction,graft this socket,placement space maintainer.ANY PARTICULAR RECOMMENDATIONS????
Thanks a Lot

Mon, 02/08/2010 - 18:49 — Gregori M Kurtz...

Implant placement in children

The rule of thumb is that males finish cranial growth around age 19-20 and females 16-17 but those are average figures. One can compare the child to their same sex parent and get an idea what they will be when done growing combine this with wrist x-rays to check closure of the plates and that will tell you if you can place. You dont indicate if the pt is male or female but even if a female may be too young and you will need to wait till age 17. best to extract the tooth, graft the site and place a space maintainer