When Should an Implant not be Done?

Not every patient is a candidate for implants. In certain cases - healthy roots, fragile bone, or steep bony angles - preserving natural teeth and exploring alternatives leads to better, long-term outcomes.

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There are many situations when implants are contraindicated. If these central incisors had been extracted as others recommended, it would have resulted in a crater of lost bone and an irreversible aesthetic disaster with her higher lip line.

Prior to coming to us, Ms. K was told twice to remove her healthy roots and replace them with implants. In fact, her roots are perfectly sound (Fig. 1) and should have been preserved. Because her bone is at a 45° angle (Fig. 2), too thin (Fig. 3), and has a steep labial slope, any implant would sit proud, risk fracture, and look unnatural - making implants truly the wrong choice here. These are perfectly good roots that were restored with custom posts in the root canals and temporary crowns. After Invisalign treatment to reduce the space between the teeth, she will receive her final crowns.

Fig. 1: Healthy Roots

Fig. 2: At 45 Degrees, Implants Would Be Unrestorable

Fig. 3: Bone Too Thin and Fragile for Support

Frequently Asked Questions

When are implants contraindicated?

When roots are healthy, bone is too thin or steeply angled, or when aesthetics demand preservation, implants should be avoided.

What alternatives exist to implants?

Options include preserving roots with posts, custom crowns, implant-free bridgework, and orthodontic space management.

Will preserving roots last?

With proper endodontic treatment and crown restoration, preserved roots can function reliably for many years.