 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / Dentistry / May 2009Fixed Bridge To Replace Tooth 11?
I am somewhat scared of getting an implant. It will soon be time to start the procedure but I would like to know how the dentists here feel about attaching a fixed bridge using #10 and 12 as the supports. My dentist said that 10 in general is not strong enough, he could do it but would rather me get an implant. Also, he quoted me $2600 for the tooth that he would do (not the implant). This is going to total to $5,000 altogether. Is $2600 excessive for just the tooth in NY or the states in general? > I am somewhat scared of getting an implant. It will soon be time to > start the procedure but I would like to know how the dentists here [quoted text clipped - 5 lines] > implant). This is going to total to $5,000 altogether. Is $2600 > excessive for just the tooth in NY or the states in general? In my area: implant body = $1,800. implant abutment = 525 implant crown = 1,200 total = $3,525 US A 3 unit bridge would be 1100 x 3 = $3300 US I agree that using #10 as an abutment for a 3 unit bridge is not as predictable as using #11 as free standing single implant. As far as fear of the procedure - you already had the hard part. If the OMFS can place the implant using a flapless technique - it depends on the surgeon and the presentation of the site to receive the implant - then any post-operative discomfort would be unusual as the gums are not being peeled back for access and the drilling of the small diameter bore-hole directly through the gum into the bone does not cause post-op pain in and of itself. In other words, a more predictable long-term result with no pain. > > I am somewhat scared of getting an implant. It will soon be time to > > start the procedure but I would like to know how the dentists here [quoted text clipped - 13 lines] > > A 3 unit bridge would be 1100 x 3 = $3300 US Thanks for the quick reply, tenthmed. I don't know what type of procedure he used. I was so scared of the extraction and bone graft that I didn't ask but will now. I am scared because it's been 10 weeks and the bone is still a little sore if I touch it. The hole has finally closed up with no leakage of the bone powder. The idea of drilling a screw into an already sore area is scaring me. I will have to call and see how long he wants me to wait, I think he said we can start mid-April. Maybe I should look around for the flapless technique...if this is a preferred way, why do some surgeons use another? Thanks also for the price quotes. I am not sure where you are being that you quoted an interpretation of prices but as you know people in the U.S. for the most part are really hurting financially if any of their money was in stocks or mutual funds, which are contingent on the market. So to be hit with these bills is really overwhelming. > I agree that using #10 as an abutment for a 3 unit bridge is not as > predictable as using #11 as free standing single implant. [quoted text clipped - 8 lines] > > In other words, a more predictable long-term result with no pain. >>> I am somewhat scared of getting an implant. It will soon be time to >>> start the procedure but I would like to know how the dentists here [quoted text clipped - 38 lines] >> >> In other words, a more predictable long-term result with no pain. I agree in general with tenthmed--in an average situation you will probably get a better long-term result with the implant. You shouldn't be concerned with the average situation though; if #10 and 12 are heavily filled and have good periodontal support the bridge may make good sense. $2600 for a well-made 3-unit bridge is on the low side. Remember there will be some soreness involved in the making of the bridge too. And I don't know that you should be touching over the graft so much. It could be sore from the flipper, irritation with food--or just pressing too hard! ;-) Bony changes continue to occur for up to a year or so; there will be soreness after implant placement, but shouldn't be too bad--even if a flap is used. So overall, if you can swing the implant, I'd lean that way--unless the condition of the teeth is such that a fixed bridge would be too sensible. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Steve, just to clarify, the $2600 was the price for just the tooth after the implant, not the 3 unit bridge. The implant + tooth will be about $5,000. I am not touching the graft site much, just touched it a few times very high up and the vertical bone that sticks out (above where the tooth was, the ridge looking bone) on the gum is sore. But I'll leave it alone and just hope it goes away. Yup, the soreness of grinding down 2 more teeth isn't a great prospect either <sigh>.Thanks for the advice, I'll keep thinking, will also get a consult at NYU, for whatever that's worth. I know people who were happy with their implants there but this is forever and I think I'd rather spring for the extra money and be confident with my own oral surgeon. On Mar 18, 2:24 pm, Mark & Steven Bornfeld <bornfeldm...@dentaltwins.com> wrote: > >>> I am somewhat scared of getting an implant. It will soon be time to > >>> start the procedure but I would like to know how the dentists here [quoted text clipped - 59 lines] > Brooklyn, NY > 718-258-5001 > Steve, just to clarify, the $2600 was the price for just the tooth > after the implant, not the 3 unit bridge. The implant + tooth will be [quoted text clipped - 7 lines] > implants there but this is forever and I think I'd rather spring for > the extra money and be confident with my own oral surgeon. If it's the surgeon(s) we discussed, you're right being confident. You'll do fine. If the graft is a little irregular and there's an edge, then it's natural to have a little soreness if you're pressing down over the edge--it's likely just the soft tissue overlying the graft. This will remodel and lose any sharp contours over time as it heals. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > ...will also get a consult at NYU, At NYU, you can't go wrong with Dennis Tarnow. World famous clinician and lecturer. An implant "rock star". >> ...will also get a consult at NYU, > > At NYU, you can't go wrong with Dennis Tarnow. World famous clinician > and lecturer. An implant "rock star". I don't know that it's possible for a patient to "request" an instructor. My brother did a prosthetic case with Tarnow back in the day. About 25 years ago I attended a lecture of his in which I heard the term "guided tissue regeneration" for the first time. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I actually know someone who worked with him. He has an excellent reputation but he is not the one to work on the patient, it's always a student. Even if he is supervising by luck, he is not the one doing the implant...wish he were! On Mar 18, 6:07 pm, Mark & Steven Bornfeld <bornfeldm...@dentaltwins.com> wrote: > >> ...will also get a consult at NYU, > [quoted text clipped - 12 lines] > Brooklyn, NY > 718-258-5001 > I am somewhat scared of getting an implant. It will soon be time to > start the procedure but I would like to know how the dentists here [quoted text clipped - 5 lines] > implant). This is going to total to $5,000 altogether. Is $2600 > excessive for just the tooth in NY or the states in general? This is not an easy question without knowing the occlusion. I would try to avoid canine guidance using a sole implant. Why did you lose a canine? If you have anterior guidance by using teeth 6 thru 10, then either an implant or bridge would work. I think a bridge would be better if this is not the case. David DiBenedetto, DMD, author of "Insider's guide to gum disease, orthodontics, and dentistry. What is not taught in dental school." On Mar 18, 5:03 pm, oralhea...@comcast.net wrote: > > I am somewhat scared of getting an implant. It will soon be time to > > start the procedure but I would like to know how the dentists here > > feel about attaching a fixed bridge using #10 and 12 as the supports. > > My dentist said that 10 in general is not strong enough, he could do > > it but would rather me get an implant. David, I don't know what you mean by canine guidance. I lost the canine because it was an old root canaled tooth that developed a fistula in the gum, had surgery to look for a crack, closed up, supposedly fine. Then the fistula returned a year later and the dentist said it's a goner. Are you saying not to get an implant for just tooth 11? No sure what you mean by using 6 through 10. > > Also, he quoted me $2600 for the tooth that he would do (not the > > implant). This is going to total to $5,000 altogether. Is $2600 [quoted text clipped - 9 lines] > David DiBenedetto, DMD, author of "Insider's guide to gum disease, > orthodontics, and dentistry. What is not taught in dental school." >David, I don't know what you mean by canine guidance. Dear Banjo, It is safe to ignore the vanity book author. > On Mar 18, 5:03 pm, oralhea...@comcast.net wrote:> On Mar 18, 9:28 am, goldbanjo <goldba...@gmail.com> wrote: > [quoted text clipped - 10 lines] > dentist said it's a goner. Are you saying not to get an implant for > just tooth 11? No sure what you mean by using 6 through 10. All restorative dental work depends on your functioning occlusion. Period. If you have canine guidance at tooth # 11, I would probably avoid an implant. It is very uncommon to lose upper canine tooth. It is the MOST IMPORTANT TOOTH in your mouth. Other factors to consider, what is the condition of your upper anterior teeth? Will it be difficult for the dentist to match the color of your front teeth? How hard do you bring your teeth together? Do you smoke? 6 through 10 mean the other anterior teeth in your upper jaw, 6 is the other canine, 7,8,9,10 are the incisors. The only acceptable occlusal schemes are anterior or canine guidance. a site I got from google to explain canine guidance: http://www.dental--health.com/biteocclusionpohl.html I do not recommend group function. David DiBenedetto, DMD. > > > Also, he quoted me $2600 for the tooth that he would do (not the > > > implant). This is going to total to $5,000 altogether. Is $2600 [quoted text clipped - 9 lines] > > David DiBenedetto, DMD, author of "Insider's guide to gum disease, > > orthodontics, and dentistry. What is not taught in dental school." On Mar 19, 6:30 pm, oralhea...@comcast.net wrote: > > On Mar 18, 5:03 pm, oralhea...@comcast.net wrote:> On Mar 18, 9:28 am, goldbanjo <goldba...@gmail.com> wrote: > [quoted text clipped - 29 lines] > > David DiBenedetto, DMD. David, I will have to leave the occlusal thing to my dentist. I can't imagine him giving me a tooth that's not exactly in the position it was before It won't be a problem matching the color, I don't smoke and I don't know what you mean by group function. I knew what 6 to 10 meant but didn't understand what that had to do with tooth 11. Thanks for the site. New B, I haven't seen you in a while and appreciate any words you offer so thanks much as always. > > > > Also, he quoted me $2600 for the tooth that he would do (not the > > > > implant). This is going to total to $5,000 altogether. Is $2600 [quoted text clipped - 9 lines] > > > David DiBenedetto, DMD, author of "Insider's guide to gum disease, > > > orthodontics, and dentistry. What is not taught in dental school." >> It is the MOST IMPORTANT TOOTH in your mouth. Such a sweeping generalization.What complete and utter pile of manure. >>The only acceptable >> occlusal schemes are anterior or canine guidance. A sanctimonius and erroneous fallacy. >> I do not recommend group function. Group function is acceptable and natural in a myriad of patients. >New B, I haven't seen you in a while and appreciate any >words you offer so thanks much as always. See comments above and know that it is absolutely brilliant to ignore the know-it-all narcissist DDB. Best wishes, I think what happens here sometimes is that the technical talk goes over the patient's head (I still don't know what group functions means, unless it means the total occlusion, not just the anterior and canine teeth mentioned above...but why should I have to figure this out, most people wouldn't have any idea) and the patient or lay person here is the one asking the question. So we are left as confused as when we wrote the original post. Not you, New B or the regulars here but it would just be good to gear the answers to what the poster can understand. No sense also scaring someone by saying they just lost the most important tooth in their mouth...I mean how do you think that hits me, David, if you're reading this? NewB, you give me comfort by refuting that...thanks. It just causes anxiety and the tooth is gone, nothing I can do about it so it's better to just go on from here and be helpful. Scaring isn't helpful! > On Thu, 19 Mar 2009 16:05:13 -0700 (PDT), goldbanjo > [quoted text clipped - 21 lines] > > Best wishes, > I think what happens here sometimes is that the technical talk goes > over the patient's head (I still don't know what group functions [quoted text clipped - 5 lines] > but it would just be good to gear the answers to what the poster can > understand. OK. Losing a cuspid is bad (losing any tooth other than a 'wizzie' is not good). What the vanity author does not understand is that it isn't the occlusion (how the teeth 'mesh'), but the occluDING (how the person clenches, grinds, etc.). Group function means that as a person slides their jaw to the side, all of the posterior teeth are in contact with each other through the whole affair. Cuspid guidance is when the cuspids bump before the premolars and molars, which 'discludes' the other posterior teeth. Practicing dentistry in the real world demonstrates that cuspid guidance pretty much only exist in text books and 'perfect' dental recontructions of occlusion. It isn't very common in the natural dentition. The ubiquotous author believes (as does a lot of other dentists) that 'perfect occlusion' will cure all ills. First of all, it will not. Second of all, it is virtually impossible to achieve. Third, it can cost $40-60 THOUSAND dollars for the attempt. 'Perfect' occlusion (with cuspid guidance) is more resistant to the destructive forces of clenching and bruxism, but it will not stop them. DB hasn't figured that out yet and believes all of the propaganda he has paid good money to listen to. *If* a patient is clenching, those forces need to be reduced (an NTI device is the best thing I have found). Nice for a guy to argue about science and research when his eyes are closed. :-/ Steve Fawks >> I think what happens here sometimes is that the technical talk goes >> over the patient's head (I still don't know what group functions [quoted text clipped - 43 lines] > :-/ > Steve Fawks Don't get me started on the gnathologists. I remember suddenly becoming aware at an alumni day lecture at NYU that canine rise was what everyone should have--and they have the studies to prove it. This of course requires full-mouth reconstruction on a fully-adjustable articulator. I'm sure there's something to it--after all, you guys all use the NTI, which if my understanding is correct actually depends on a similar mechanism--that anterior disclusion greatly diminishes the muscular forces that can be exerted by the elevators of the mandible. Obviously it's much quicker and easier to achieve with an NTI than it is with full mouth reconstruction, but how much fun is that? So all the prosthodontists doing full mouth reconstruction for achievement of canine rise can look at us guys doing single crowns on broken down and tell us (with a sneer) that we're doing not "restorative" dentistry, but "conformative" dentistry. But that seems to imply that most patients in good dental health are walking around with natural canine rise. I don't see it. I see group function. May Frank Celenza strike me down! Oh, I also remember when we were in school and restoring full denture cases in centric relation (RUM position of the condyles). A few years later Frank Celenza Sr. was telling us that was no longer necessary. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I find (anecdotal) that Migraine patients are more likely to have cuspid rise than group function. Cuspids allow for tremendous clenching forces to be exerted. Cuspid rise will really mess up a "clencher". AC >>> I think what happens here sometimes is that the technical talk goes >>> over the patient's head (I still don't know what group functions [quoted text clipped - 65 lines] > > Steve Yep, Once the condyle seats, and the musculature relaxes, you may find persistent symptoms if there is cuspid contact in excursion with an NT in place. Recently had a refractory patient that could get "in front" of the DE and had cuspid contact 6/27. This did not show up for 8+ months, and was only determined after a severe headache episode. The cuspid contact in humans relates to the familiar domesticated carnivores such as the dog and the cat. Since humans are omnivores, we have the same characteristics as the herbivores and carnivores. This combination, though thought to be an evolutionary advantage, <if you believe in such> results in nocturnal gnashing. Especially in the hungry. Take that ya'll frakkin' gnathologists, know nothing freak shows !! <hehehe> ############################################## Up Next: Occlusion of the Australian Salt Crock, American Gator, Opossum, Armadillo, and freshwater Gar. @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ Next month we wil explore the occlusion and teeth of the Bovine, Ovine, and Equine. The cloven hoof that chews cud, versus the Porcine. And.... " how to kosher chicken and venison " ! %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% Stay tuned folks !!! >I find (anecdotal) that Migraine patients are more likely to have cuspid >rise than group function. [quoted text clipped - 73 lines] >> >> Steve > > I think what happens here sometimes is that the technical talk goes > > over the patient's head (I still don't know what group functions [quoted text clipped - 43 lines] > :-/ > Steve Fawks Unfortunately, most dentists looks at trees and not the forest. Most equilibration is simple. Where do you get the information that major crown and bridge is needed to get someone out of group function? ABSURD. What planet are you on? The NTI, it is like a passifier. You wear it too much and you get an anterior open bite. Look at any three year old who uses a passifier? So the problem gets worse. By wearing an NTI you make the problem worse. NTI is only for people with skeletal jaw problems. The upper canines are strongest and most important teeth in the mouth. They are meant to take tipping forces. Implants are not. Occlusion and jaw positioning determines restorative work. If you don't look and understand occlusion you won't understand how the teeth, the jaws and the tmj work together. The only patients in my practice who don't have anterior guidance or canine guidance are because they have skeletal discrepancy. None of my patients have to wear night guards or NTI. The only patients who have to wear a night guard are patients who clench. David DiBenedetto, DMD, Author of "Insider's guide to gum disease, orthodontics and dentistry. What is not taught in dental school." Also, http://jada.ada.org/cgi/content/full/138/1/27 You being the prime example!! Steve Fawks > Unfortunately, most dentists looks at trees and not the forest. BTW, this is further proof of your stupidity. I have many patients that have been wearing NTI's for over EIGHT YEARS. Not one single open bite. You sir are... well I just won't go any further. Steve Fawks > The NTI, it is like a passifier. You wear it too much and you get an > anterior open bite. Hey twerpie,,,,, pacifiers don't create open bites, the suckling action does > goldbanjo wrote: > > I think what happens here sometimes is that the technical talk goes [quoted text clipped - 44 lines] > :-/ > Steve Fawks Unfortunately, most dentists looks at trees and not the forest. Most equilibration is simple. Where do you get the information that major crown and bridge is needed to get someone out of group function? ABSURD. What planet are you on? The NTI, it is like a passifier. You wear it too much and you get an anterior open bite. Look at any three year old who uses a passifier? So the problem gets worse. By wearing an NTI you make the problem worse. NTI is only for people with skeletal jaw problems. The upper canines are strongest and most important teeth in the mouth. They are meant to take tipping forces. Implants are not. Occlusion and jaw positioning determines restorative work. If you don't look and understand occlusion you won't understand how the teeth, the jaws and the tmj work together. The only patients in my practice who don't have anterior guidance or canine guidance are because they have skeletal discrepancy. None of my patients have to wear night guards or NTI. The only patients who have to wear a night guard are patients who clench. David DiBenedetto, DMD, Author of "Insider's guide to gum disease, orthodontics and dentistry. What is not taught in dental school." Also, http://jada.ada.org/cgi/content/full/138/1/27 Wrong again. It's the "occluding". Steve Fawks > All restorative dental work depends on your functioning occlusion. Right-O ! >Wrong again. > [quoted text clipped - 3 lines] > >> All restorative dental work depends on your functioning occlusion. On Mar 18, 5:03 pm, oralhea...@comcast.net wrote: > This is not an easy question without knowing the occlusion. I would > try to avoidcanineguidance using a sole implant. Why did you lose acanine? [quoted text clipped - 4 lines] > DavidDiBenedetto, DMD, author of "Insider's guide to gum disease, > orthodontics, and dentistry. What is not taught in dental school." This month's issue of JADA(Journal of American Dental Association), May 2009, page 587, by "guru" Frank Spear: "Another broadly applied "truth" was that a "maxillary canine implant cannot serve alone at the primary guidance." This was discovered to have less to with the implant than with what the patient does with his or her teeth and why the canine is missing in the first place." What does this mean? It means why was the canine lost and how strong is the functional occlusion? |
Reply to this Message |
 Sign In
 Join
 My Latest Posts My Monitored Threads My Blog My Photo Gallery My Profile My Homepage Start New Thread Enable EMail Alerts Rate this Thread
|
©2009 Advenet LLC Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.