What is involved with a bone graft and placement of a fixed bridge on my lower front teeth?

4 months ago the adjacent tooth was extracted after it had broken off and an abscess formed with infection of the gum. This required oral surgery and, either due to the resorption or the extraction, much of the bone for that tooth was lost. I am interested in determining the best options moving forward and have been advised that I will need to have the tooth extracted, a bone graft, and a bridge placed to cover the two-tooth gap.

Doctor Answers 1

Bone grafts and Bridges

Raceterps,
    I'm sorry your tooth broke and that you've had to suffer through the abscess. It sounds like you're saying you've had one extraction and now need another.  If you haven't had the second extraction, then that may help make it easier by extracting the tooth that and grafting in the socket the tooth was just removed from--filling the hole that was just created is much easier than adding bone to a healed area. Grafting an area after an extraction healed is generally more involved, more expensive, and takes longer to heal fully. That being said, it's done routinely and may be what you need.
     Being a lower front tooth, you're in a better place esthetically than most other areas. Sometimes you can get away with doing a bridge without ever grafting the area at all. Granted, there will likely be a defect or dented-in area, but if it's your lower front teeth most of that stays hidden from view. Ideally, you'd replace those teeth with implants (or sometimes just one implant holding two teeth, but the scenario has to be just right) so you wouldn't need to involve the neighboring teeth at all, but it sounds like you don't have adequate bone for implants, so a bridge may be the way to go.
     I would recommend seeing a dentist or oral surgeon who uses a cone beam CT scan (CBCT) to get a 3-D visual of what bone you have available so you can talk through your options. Without seeing your xrays and/or photographs it's impossible to tell you exactly what your options are, but the dentist/surgeon who you visit will be able to explain why different treatment options may or may not apply to you.

Best of luck!


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