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

I have an implant on the upper right first molar. Can a bridge be made by connecting the third molar to the implant because I have just lost the second molar.

Doctor Answers 11

Connecting teeth and implants

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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.

Cleveland Dentist

Bridge connecting teeth and implants

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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. 

Should Natural Teeth Connect to Implants?

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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!

Implants Work Best Without Attaching to Natural Teeth

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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.

Wendy S. Spektor, DDS
Bellevue Dentist

Connecting Natural Teeth To Dental Implants

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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!

Howard Perlmutter, DMD
Paramus Dentist

Connecting Implants to teeth

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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!

Peter Mann, DDS
Manhattan Dentist

Connecting dental implant to natural tooth

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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

H. Ryan Kazemi, DMD
Bethesda Oral & Maxillofacial Surgeon
5.0 out of 5 stars 5 reviews

Implants and teeth bridges

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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.


Dental implants should not be bridged to a natural tooth

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Especially a third molar.  Dentists that push the limits of accepted methods and techniques usually do so in low risk areas, in this case in the anterior.  Bite forces increase as you go further back, and the forces on the third molar would stress the bridge, the implant and the bone supporting it all.

It always comes down to, "just because you can, doesn't mean you should."  If you want your investment to last as long as possible, this is a high risk option.  Some people are ok with spending the money on things like this knowing that it may not last as long as alternatives.

As stated elsewhere, this is a controversial approach among dentists.  Some say it is ok, some do not, but even the ones that say it is ok would likely NOT do it if it involved a third molar.

Implant to Tooth Bridge

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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.

Marc Zive, DMD
Springfield Dentist

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.