Apologies for using Irish/Canadian dental numbering but here's the question: Terrible teeth with multiple fillings & root canal treatments. After many failed crowns I had 14 (upper rt 4) implanted 2yrs ago-final crown only 9 months ago. 15 was extracted & bridged with a cantilever off 16 but the 6 is heavily filled, missing palatal side & has a sinus to gum. Oral surgeon wants to extract 6 and bridge 16 to 14. I'm terrified about longevity & will require sinus graft. Is it best option?
Dental Implant Bridge vs Crown?
Doctor Answers 10
Today, it's often better and less expensive long term to have successful implants rather than complicated dentistry on questionable teeth. Dentists usually try not to combine implants and teeth with bridges, but I have seen cases where this was successful. A second opinion would be a good idea here since it's impossible to be more specific without an exam and x-rays.
I almost always recommend going with the implant over a bridge. In the case where aesthetics are concerned, a bridge can be more predictable. As for longevity, I believe the implant will likely win. Most implant decisions boil down to cost, so if you can afford it (and wait for the tooth to come) I would say go with the implant.
Every situation where one has to fill the missing tooth space is unique and needs a number of considerations addressed to find the right answer. You sound like you have had ongoing trouble with failing crowns (that problem may need to be addressed separately by your dentist).
In your situation, if the teeth are strong enough, a bridge is still a good solution. It's a relatively fast process-like the crown making process that you have had before. IF you are having on-going problems around your crowns, then having a bridge only ups the ante for future problems, as whatever problem happens to one part of the bridge, then affects all three teeth in the bridge.
Implants are less susceptible to cavities under crowns, so that may lower your overall risk and increase the longevity of your dental work. You sounds like you have a good specialist. This is probably the right direction. Make sure to discuss your specific fears with them so they can find a way to make you comfortable.
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It would be helpful to know the exact teeth that are being questioned and see a current X-ray and scheme of your occlusion (bite). These diagnostics are important in the best treatment alternative and recommendations. Generally, it is best to use implants to support crowns and bridges and avoid combining them with natural teeth. Please feel free to send your X-ray for a more precise and relevant advice.
Anytime a cantilever is involved, the potential for failure of that cantilever is significantly higher than any other restorative treatment option we can offer to patients.
Based on the fact that 16 is heavily filled, missing the palatal side, AND is currently being used as a cantilever, I agree with your oral surgeon that bridging 16 to 14 is the best option, assuming that placing an implant in 15 is not an option.
Sinus lifts/grafts are fairly routine and in the hands of a well-trained surgeon, you should feel comfortable about the probability of success. While some discomfort is to be expected with this type of procedure, it will provide you enough bone so that an implant of appropriate length and diameter can be placed to properly support a fixed implant bridge.
Chewing forces on teeth with many fillings and a history of failing restorations leads to tooth loss. Implants are among the most predictable and longest lasting treatments. The advice of your surgeon is exactly how I would advise.
Web reference: http://www.drtimmerman.com/services/restorative/dental-implants/
These are challenging questions to answer without knowing more information. Even knowing your age will help. Why did all the other work fail? Bite problems? TMJ? Grinding?
Generally speaking, dental implants are an excellent treatment choice in cases of missing teeth or to replace very badly broken down teeth. The challenge that implant dentists face is whether to restore the badly broken down tooth and hope it will last a reasonable amount of time or recommend a dental implant which can be predictable in the hands of a good implant surgeon and restorative dentist.
Without more information and x-rays, I am not comfortable suggesting treatment. You might want to consider having another consult with your dentist and ask the questions I mentioned above.
I hope this helps.
Hello,
Only with a complete clinical exam and full mouth X-ray and I could give you a good answer.
Thank you,
Dr. Barba
With this type of treatment we cant really give you a well defined consultation. For this type of case you would need to be in a dental chair so we can check the bite,,oral health,,periodontal issues and bone density. Sinus lifts are normal as a pretreatment for implants..Get a second opinion,that would be best..
Your question has many facets but in general, it is always preferable to save natuaral teeth if they have a good long-term prognosis. If they do not, implants and implant bridges have a hight success rate.
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.
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