Can a Bridge Be Made on an Implant and Connect to a Tooth

Under no circumstances should you use an implant in the first molar position as an anchor for a bridge connecting a wisdom tooth.  This is contraindicated and is a situation that is set up to fail.  The chewing forces are too strong that far back in the mouth to try this.  Natural teeth flex slightly when chewing due to the periodontal ligament that attaches teeth to bone.  Dental implants do not have this ligament and do not flex when chewing forces are applied.  Over time too much force would be placed on the implant causing the bridge and ultimately the implant to fail. Not a good idea!

Hi,

Connecting the third molar (natural tooth) to first molar (implant) is not recommended for the following reasons:

1. implants and natural teeth have different type of connection to the bone and there are reports to suggest problems in long term.

2. Third molars are highly prone to gum disease and decay and often require extraction for best hygiene access. Its use to support a bridge is not recommended.

3. Upper back area has the high forces of chewing and bone quality is usually thinner than other areas. Best design is one implant per missing tooth. Even implant bridges are not recommended in this area.

Hope this is helpful

Dr.  Kazemi

Simply put I do not recommend connecting implant supported teeth to natural teeth. Natural teeth are connected to bone with a resilient ligament which is not the case for dental implants. This difference in resiliency could lead to many problems such as intrusion of the natural tooth or the fracturing of implant or screw components. This risk is ill advised due to other alternatives which are more reliable in replacing missing teeth. Your dentist will be able to give you the specific details as to how it applies to your circumstance!

I don't really recommend attaching an implant to a natural tooth in a bridge, even though I have done it successfully. Using a third molar as one of the abutments will increase the chance of problems. A better choice would be another single implant. A cantilever off the current implant might be a second choice.

In the old days we did do Tooth to Implant Bridges.  We have more information today and discourage it although it is up to the individual dentist.

 Since you are talking about doing a bridge from a wisdom tooth to an Implant, I would discourage it anyways because wisdom teeth are not easy to work on and not easy to reach in most instances.

It has been shown that you have successful treatment when you either put another Implant in the site for Tooth # 2(the missing tooth) or have a cantilever tooth made off of Tooth # 3(the upper right first molar).  The costs may be similar but you want what will work and last longest. Much depends on your bite and many other considerations that a dentist must decide. Good question-Do a consultation to find out what is right for you.

It is not recommended in connecting an implant to a third molar. This molar usually has poor root anatomy and lenghth. The tooth may move and put unwanted stresses on the implant.

Adding a pontic crown onto the implant may again cause it to fail.

Best long-term solution is another individual implant.

 

The practicality of connecting an implant to a natural tooth using a bridge is the subject of much controversy in dentistry.  There has not been any substantial evidence to support or refute this dental procedure.  The majority of dentists do not suggest connecting an implant to a natural tooth.  In any case, nothing should be attached to an implant that places it under any functional stress until the bone has grown into the implant surface.  Bone attachement stabilizes the implant and takes about three months.

The natural tooth is supported in it's socket by the periodontal ligament.  This ligament acts as a shock absorber for the tooth when it is put under compression during clenching, chewing, etc.  It provides a small degree of tooth mobility so that the tooth does not fracture.

The bone which grows into the implant surface results in a rigid body in the jaw.  There is no give in this system.  Stresses are prevented by carefully adjusting the occlusion so that the implant restoration receives minimal occlusal forces.

When a bridge is used to attach a tooth to an implant, the tooth end of the bridge retains the inherent mobility of the periodontal ligament while the implant side is fixed and rigid.  This difference can result in the bridge retainer attached to the tooth separating, the implant failing due to loss of bone attachment from the motion applied to the bridge or the tooth or implant body being intruded or extruded from the jaw resulting in an unbalanced bridge and potential occlusal interferences.

Personally, I prefer not to risk the longevity of the bridge by using like abutments (tooth/tooth or implant/implant).  You should discuss the long term survivability of a tooth to implant bridge with both your surgeon and restorative dentist.

I reccomend you cantelever a fake tooth off of the crown that will be attached to the implant. Have the lab make a "distal rest" off the floating, fake tooth that will rest on the chewing surface of the wisdom tooth (3rd molar). You get a bridge without having to cut the heck out of the wisdom tooth. This will allow the natural movement of the wisdom tooth in it's ligaments, but still allow full suport of the fake tooth.

 

Connecting dental implants to teeth is a controversial topic in dentistry.  While some dentists have  no problems with it, other dentists don’t believe in splinting implants to teeth.   The dentists who don’t splint implants to teeth believe that the Periodontal Ligament around teeth allows for more mobility than the implant tightened in bone.  The studies have not been conclusive.   The dentists who splint implants and teeth, especially in the posterior maxilla believe that the bone is soft and allows for about the same amount of movement as the periodontal ligament around teeth.

The other issue is that many 3rd molars are poor abutments for bridges.  Meaning they are often not fully erupted, they may be severely angled, or have short roots.  If you are using a 3rd molar you want to be sure that it's a good tooth so the dental work lasts you for a long time.

All these issues must be explored between you and your dentist to make an informed decision.  Good luck with your treatment!

The old concept from 80-s suggested that teeth could be connected with implants in permanent prosthesis. Multiple research showed that this approach could lead to multiple complications. It can lead to tooth eruption, failure of the bridge, breakage of the screw inside of the implant or the tooth crown. Current approaches do not allow in any way to connect teeth and implant. Besides that wisdom teeth/ third molars due to their position in the arch are not used for permanent restorations or prosthesis. You will recieve much more predictable restorations as a single tooth which will be implant supported. Single crown on the implant has much better long term  prognosis in comparison to multiple unit prosthesis.