What is best treatment option for a canine tooth?

Endodontist says I may not have enough bone for an implant (even with a graft) because canine root is so big and gives root canal only a 50/50 chance of working due to location of resorption. A bridge seems too destructive to the neighboring teeth and may not last very long. Is a partial denture an option? Is it best to do a bone graft right away, even though I may not end up being able to do an implant? Would having a bone graft lead to better outcomes for bridge or partial denture?

Doctor Answers 2

If possible save the tooth but if you must lose it do a bone graft.

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I would discuss this with a doctor who does implants and bone grafts.  There are many types of bone graft.  I would also talk to a restorative denture with a lot of varied experiences

Bridges have been shown to last as long as implants and crowns.

Bridges can be done with resin bonding and require minimal tooth preparation.  I recently did two implant abutments and crowns on a patient who had no bone but wanted implants for congenitally missing teeth 7 & 10..  She did not want a removable flipper.

We placed Resin Bonded bridges from 6-8 and from 9-11 with NO TOOTH PREPARATION that she wore for three years waiting for her to get a little   older and have onlay bone grating.  One side needed two grafts.  
The bridges were removed when the surgeon placed the implants and then recemented for another 6 months of healing.  

The bridges were in for 3 1/2 years.  I have seen resin bonded bridge last 20 years.  She now has implant born crowns but in retrospect she is not sure if she would do implants again considering multiple surgeries.

I love doing implants but I refer more difficult cases to surgeon for grafting and implants if the patients want IV sedation.  

Ira L Shapira DDS
Diplomat, American Academy of Pain Management
Diplomate, American Board of Dental Sleep Medicine
Regent and Fellow, International College CranioMandibular Orthopedics

Implants still might be the best option

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I would consult with an implant specialist as many endodontists don't have as much experience in implant dentistry and an implant is by far the best option.

You can search for ones in your area through the AAID (American Academy of Implant Dentistry)

Be sure to look for someone who is a Associate Fellow or Fellow as they will be able to provide the best care.

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