Two Missing Teeth. Space Too Small for Two Implants. Options? Dentist Answers, Tips
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Two Missing Teeth. Space Too Small for Two Implants. Options?

Hi Doctors, my husband has one missing tooth #5 for years, and the space became smaller. However, another one tooth (#4) needs to be extracted. If he has one implant in the place the two missing teeth left, this would leave 3mm empty space. However, the place is not enough for two implants. I would like to know what would be a good option in this case? Thank you for your time.

11 Doctor Answers | Asked by amanda19 in California
+2

Wax-up to get a preview

Hey Amanda19, There are several options for this situation.  If there are just 3mm remaining than one implant should be able to support both crowns.  The dentist can ask the lab to create a wax-up to give you a preview of the crowns.  If you are satisfied with the esthetics of the wax-up and the dentist thinks there’s enough bone to place the implant in the proper position then you’re all set.  In the rare instance where esthetics are compromised,... more
+1

Insuficient space for implants

When you do not have enough  space for 2 implants there are few options that you might consider for an esthetic outcome. You can have orthodontic treatment to create needed space for second implant or close it, so you might not need it. You need to obtain orthodontic consultation to determine what would be the best for you. Another option is to place one implant ant make two crowns to fill the space. The best treatment option for you can be determined by dental specialist who... more
+1

One implant in space of two teeth

The site of two small missing teeth or shifted adjacent teeth can be restored with either two narrow neck implants or single regular neck implant. Diagnostic step with proper wax-up model is an adequate way to identify the contours of final restorations, which will dictate the position of the implant. Depending upon the proximity of the sinus floor in the upper premolar area implant can be placed in the site of the 1st or 2nd premolar. The restoration containing implant PFM crown with... more

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+1

One implant can replace two missing teeth.

There's no reason that every missing tooth has to be replaced with it's own implant. The first question in doing an implant is always whether there is enough bone. As long as a comprehensive exam has been done, and the case well planned (by both surgeon and restoring dentist), a good lab should be able to make a crown that blends in well with the adjacent teeth. 
+1

Space for implants

I would suggest to have an implant placed and a crown with a small extension to close the space.
+1

One implant often works just fine for two adjacent premolars (#4 and #5)

Hi Amanda19 Its always hard to answer these questions without doing an exam first.  But if the remaining space after one implant/crown is only going to be 3mm, it is hard to imagine why one implant cant be used to fill the whole space.  Its not that hard to make a single unit crown look like two teeth.  Perhaps the dentist will have to work with his/her lab to come up with a creative esthetic solution, but it really shouldn't be too difficult.  And the implant... more
+1

This is often the case.

However, there may be several solutions.  First of all, the bone should be evaluated 2 months after the extraction of #4 (grafting may be necessary at the time of extraction or depending on the defect, later, as well).  Once one knows what the quality of the bone is al well as the distance between remaining teeth, here are some options:    1: orthodontically create the ideal space (it sounds like a complicated proposal, however depending on what is behind #4 space, it can... more
+1

Two teeth replaced with one implant

Great question, Amanda, with many possible answers. Most importantly, is there sufficient bone in the area to suport an implant. If so, a single implant could be used to support a cantelever bridge (one tooth hanging off the implant supported tooth, a carefuly designed single crown that aesthetically appears as if it was two premolars or a single molar sized crown to fill the space. Which is best will depend on the condition of the surrounding teeth, functional concerns,... more
+1

Can Two Missing Teeth Be Replaced With ONE Implant

Great question Amanda! Unfortunately, there is not one simple answer. The MOST IMPORTANT consideration in your husband's case is to ensure that there is a clearly defined plan BEFORE any implants are placed. His entire mouth must be evaluated by the COSMETIC or RESTORATIVE dentist. It is always beneficial in a case like this to have the restoring dentist and implant dentist on the same team.  You might consider moving adjacent teeth (Invisalign), it might be possible to replace... more
+1

Space too small for two implants-Options?

How many implants are the right number when you don't have the right sized space? Your question smacks of one of my biggest irritations with dental implants-namely a specialist might tell your husband- "No problem, we can just put one implant in there and your dentist can put two teeth on it".  The biggest problem I see in implant dentistry is that not enough thoughtful planning and direction by the dentist who makes the crowns is done beforehand. The key to a case... more
+1

How much space do you need for an Implant?

When you are missing one tooth, you do not always have room for a Implant.  There are many reasons why Implants won't work including the location of the other roots of your teeth, bone thickness, esthetics's, and more..  One great option for the situation you are describing, is  using one Implant with a cantilever tooth attached. What that means is that if you have room, you place one Implant ideally for replacing one tooth and then the lab constructs 2... more
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