When I was in middle school (now 21) I fell and injured one of my front teeth. I have had three root canals, and a surgery to remove the root of my tooth. After a couple of years the tooth is now becoming a huge pain again. My Endodontist has said she could do the same root removing surgery again, or the tooth should be extracted. What do you think would be the best option. It is the front left tooth on top. If I get it extracted, should I get a bridge or an implant being 21. Thanks.
Implant or Bridge For A Bad Front Tooth?
Doctor Answers 11
Promoted Local Answer
If tooth is not restorable predictably with 85% + prognosis for long term success, then extraction is the best option. Dental implant is the ideal option for replacement. Bridges have poor long term prognosis.
Dental Implant Recommended for a Failing Front Tooth
When a front tooth has multiple failed endodontic treatments along with failed endodontic surgery, it is best to have the tooth removed along with the active disease process. If the 2 adjacent teeth next to the injured one do not have any restorations, decay or periodontal disease then I would highly recommend a dental implant with a single implant supported crown. The restoration is very easy but the esthetics can be quite challenging. Meticulous esthetic planning should be done by the restoring dentist, periodontist and dental laboratory with approval by the patient. It is recommended that you have both soft tissue grafting and bone grafting once the tooth is extracted. Soft tissue grafting can be done at the time of implant surgery but this would depend on the periodontist. The head of the implant should be at both the bone level and the CEJ of the adjacent teeth. If this is not possible, then multiple grafting procedures (bone and soft tissue) might have to be performed before implant placement. The restoration can be a cement retained implant crown with a non-metal custom abutment. I would also make sure there is a thick band of soft tissue covering the root of the implant so the titanium will have no chance of being visible.
Dental Implant Over Bridge
Usually, after so many endodontic retreatments, the prognosis of additional endodontic treatment is significantly lower. The chance that you will have another problem with it again is very high. Because of your young age, I would definitely choose to go with a dental implant rather than a bridge. A bridge requires cutting down 2 adjacent healthy teeth, compromising their longevity and making it difficult to clean/floss in between them. On the other hand, a dental implant will preserve your adjacent teeth and will address only the problem area (missing tooth). I think your best treatment option is to extract the tooth, use a bone graft to reconstruct/preserve bone and place a single implant. Occasionally a gum graft will also be necessary to preserve good gum tissue, protect the area from trauma and create a symmetrical, even look.
Best of Luck,
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Implant or Bridge For A Bad Front Tooth?
The two options you have presented both have their advantages and disadvantages.
The biggest disadvantage to doing a Bridge is that you are going to have to prepare the two teeth adjacent to the tooth being removed. Without pictures or X-Ray pictures, it is hard to say if this is a reasonable treatment option.
The Implant option is excellent as it is a single tooth replacing a single missing tooth but there are some factors that have to be considered before deciding on an Implant. The amount of bone in the area, the overall appearance of your teeth when you smile. the surrounding teeth and anatomical structures (sinus, adjacent teeth roots, angles etc), gum condition and contours etc. All of these things come into play when placing an Implant in what we call the "Aesthetic Zone" Implants are amazing in their ability to replace missing teeth but they are not perfect and the Aesthetics of an Implant in the front of your mouth should be a high priority.
At 21, and with an existing tooth, you are likely to have good bone in the area. Of course the removal of that tooth has to be done very conservatively to preserve that bone.
Bottom line is that both options can offer Great results but both have positives and negatives, depending on the case they are being used in. In your case a little more information is needed.
Your Dentist will be able to go over these two options in much more detail, I'm sure, but hopefully this gives you a few things to think about, and maybe ask about.
Implants Are Best Option for Many Patients
Hi, thanks for your question. Implants/implant crowns and bridges can both be extremely esthetic/natural-looking, depending on the materials used. We typically recommend implants whenever possible, although not all patients are candidates for doing so. Reviewing medical history with your dentist as well as possible imaging will help to determine which options will be best-suited for you. Good luck!
Implant or bridge?
Without raddiographs and or photos and exam very difficutl to say... However you may want to consider the implants after all the care money and time on these teeth you may get a better long term result from the implants good luck
Kevin Coughlin DMD, MBA, MAGD CEO Baystate Dental PC
Implants is going to be a better option than bridge for adeauate conservation, esthetics and function.
Implant or Bridge for Failing Front Tooth
If there is adequate bone available or can be grafted to create a good site for the implant that would be your first choice. Depending on how high or low your lip line is and where the implant will be placed will determine how cosmetic the restoration will be. The restoration needs to be planned prior to the surgery to be sure an esthetic outcome is possible and help guide placement of the implant. If the implant restoration can not look excellent better to know ahead of time and then the bridge could be the best way to go.
Implant or Bridge for a Bad Front Tooth
It sounds like after 3 or 4 attempts at Root Canal and Surgery, you should extract the tooth. The better option then would be to place an Imolant, rather than a bridge.
An implant is your best option since you would not have to cut down the adjacent teeth to place a bridge. However, make sure you have this implant placed by a reputable periodontist, a dentist that specializes in bone and gums and restored by a cosmetic dentist. Ask to see before and after pictures of their work on anterior implants. This is a very challenging esthetic situation for any dentist to handle, so you want to make sure you are in good hands. I have seen patients with poor implant work on their front teeth which results in further loss of bone and even more challenges in restoring that tooth. Good Luck!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.