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Medical Forum / General / Dentistry / February 20051 crown bridge
Hallo! It seems like I am ready for my first bridge. My dentist took out a cracked tooth (the penultimate on the upper arch). I know I difficult is to give opinions over the net, anyway I would like to ask the opinion of the community here. He suggested a bridge anchored to one tooth only (the last one) which has a large filling already. The reason being that the other tooth close to the missing one is healthy and untouched. He admitted that this solution might not be the most stable, but he would recommend it anyway. Does anyone feel like commenting? thank you, cesco ak1802NOSPAM@REMOVEPLEASEhotmail.com > Hallo! > [quoted text clipped - 16 lines] > cesco > ak1802NOSPAM@REMOVEPLEASEhotmail.com Understandable why you would want to avoid grinding down the tooth in front of the space, but what we call a cantilever bridge as you describe is not likely to work. It could damage the back tooth, but it is even more likely to just fall out. Allowing for decent anatomy, this is an implant situation. You may or may not choose to crown the last tooth based on its own merits. Steve  SignatureCut the nonsense to reply >> Hallo! >> [quoted text clipped - 25 lines] > >Steve Yeah what he said. Beat me to the punch once again Bornfeld. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>Hallo! >>> [quoted text clipped - 35 lines] > wubbabubbazG@RBAGEyahoo.com > Take out the G'RBAGE ...but you're so much more succinct. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 A cantilever with a crown on the tooth distal to the space and an inlay rest on the tooth anterior to the space would be the minimum that I'd put in that space. But like these guys...I'd opt for an implant if the anatomy permits it. >>>>Hallo! >>>> [quoted text clipped - 39 lines] > > Steve > A cantilever with a crown on the tooth distal to the space and an inlay rest > on the tooth anterior to the space would be the minimum that I'd put in that > space. But like these guys...I'd opt for an implant if the anatomy permits > it. I have done the occasional cantilever bridge. But in this case I ALWAYS at least double-abut. And even there, I try to make a small pontic--as with two premolars (or even two premolars and a canine) with a small first molar pontic. Obviously, if the two premolars and canine are in good shape, I would strongly suggest an implant. But plenty of my patients who have lost their molars have beaten-up premolars too, and I can sometimes rationalize the cantilever. Steve >>>>>Hallo! >>>>> [quoted text clipped - 39 lines] >> >>Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > But plenty of > my patients who have lost their molars have beaten-up premolars too, and > I can sometimes rationalize the cantilever. ... I would imagine you suggest Endo/Post&Core before crowning them in this situation? Thanks SP SignatureNot a real Addy, yet >> But plenty of >>my patients who have lost their molars have beaten-up premolars too, and [quoted text clipped - 4 lines] > Thanks > SP Not because of a cantilever, that's for sure!. If I am "sitting on the fence" as far as pulpal vitality for a particular abutment tooth, using it as an abutment might well decide it for me, whether it's a cantilever or not. If I have to worry about a tooth because of a cantilever, I'm not going to do it. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > > ... I would imagine you suggest Endo/Post&Core before crowning them in > > this situation? [quoted text clipped - 9 lines] > > Steve Good. Thanks SP SignatureNot a real Addy, yet >>> But plenty of >>>my patients who have lost their molars have beaten-up premolars too, and [quoted text clipped - 13 lines] > >Steve Not quite sure what you mean here. Am thinking that if one doesn't want to prep an abutment with a large restoration or questionable pulpal health for a FPD; due to the question if future RCT may be needed on a paticular abutment due to the pulpal trauma of the preparation; I say do the endo first, then proceed with the restoration. Why roll dice when you can bet on the 'sure thing' ? BTW this approach lasts much longer than hedging. Fix it right the first time and going through that nice porcelain to do endo is a non event. Your patients' best interest should always guide your treatment plans. What will last the longest ? FPD's can always be done in stages. </soap box mode> -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > Not quite sure what you mean here. > [quoted text clipped - 20 lines] > -- > W_B Sorry I wasn't clear. What I meant was that since I'm disinclined to use cantilevers anyway, I would be even less likely to do them if I thought I would not only require multiple abutments, but likely to devitalize them too. As I said, if I've made the decision to do a cantilever knowing all this, I will do the endo if I have any question about pulpal health (as I would for any fixed bridge). Steve > wubbabubbazG@RBAGEyahoo.com > Take out the G'RBAGE SignatureCut the nonsense to reply >> A cantilever with a crown on the tooth distal to the space and an inlay >> rest on the tooth anterior to the space would be the minimum that I'd put [quoted text clipped - 8 lines] > have lost their molars have beaten-up premolars too, and I can sometimes > rationalize the cantilever. What I described is not a true cantilever. I don't like cantilevers (even double-abutted) because the porcelain always fractures off the pontic where it meets the abutment. Too much bending force, and porcelain isn't really amenable to bending. >>> A cantilever with a crown on the tooth distal to the space and an inlay >>> rest on the tooth anterior to the space would be the minimum that I'd put [quoted text clipped - 13 lines] >it meets the abutment. Too much bending force, and porcelain isn't really >amenable to bending. Just steer away from the thoughts of 'cantilevered' FPDs. They always fail. Have cleaned up enough of that type of trash to know better. Have never made one. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE -- > Just steer away from the thoughts of 'cantilevered' FPDs. > They always fail. > Have cleaned up enough of that type of trash to know better. [quoted text clipped - 3 lines] > -- > W_B Me neither. >A cantilever with a crown on the tooth distal to the space and an inlay rest >on the tooth anterior to the space would be the minimum that I'd put in that >space. But like these guys...I'd opt for an implant if the anatomy permits >it. If this is an upper posterior situation, Endo both of the abutments if pulpal health is questionable. Then 3-unit FPD Thought we were talking about a cantilever off of a cuspid for the lateral. Another option is the Mancuso style maryland bridge. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > If this is an upper posterior situation, > [quoted text clipped - 9 lines] > > -- Do you mean a MonoDont? Thanks SP SignatureNot a real Addy, yet >>A cantilever with a crown on the tooth distal to the space and an inlay >>rest [quoted text clipped - 13 lines] > Thought we were talking about a cantilever off of a cuspid > for the lateral. I thought we were talking about a premolar cantilever off a molar...and the adjacent premolar is a virgin tooth. >> Then 3-unit FPD >> [quoted text clipped - 3 lines] >I thought we were talking about a premolar cantilever off a molar...and the >adjacent premolar is a virgin tooth. OK, still say FPD or implant -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>> Allowing for decent anatomy, this is an implant situation. You may or >>>may not choose to crown the last tooth based on its own merits. [quoted text clipped - 7 lines] >> -- >> W_B >...but you're so much more succinct. > >Steve Take that to mean that I "cut to the chase" or am just to lazy to explain the whole thing. <8^]]> -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >Hallo! > [quoted text clipped - 16 lines] >cesco >ak1802NOSPAM@REMOVEPLEASEhotmail.com I don't like cantilever bridges and have never made one. Consider an implant. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > >Hallo! > > > >It seems like I am ready for my first bridge. My dentist took out a cracked > >tooth (the penultimate on the upper arch). I know I difficult is to give > >opinions over the net, anyway I would like to ask the opinion of the > >community here. > > [quoted text clipped - 11 lines] > >cesco > >ak1802NOSPAM@REMOVEPLEASEhotmail.com > I don't like cantilever bridges and have never made one. I don't like them either. I have made exactly . . . ONE. It was about 20 years ago, for a lady who already had a cantilever in that location, and wanted an improved shade and contour. My "new" cantilever is still there. (As I don't want to wreck my perfect record, I will never make another. ;-)) Of course, she is forbidden to bite on it. That's why it's still there. Cantilever bridges have better luck when the pontic space is much smaller than the abutment tooth. Still, you're depending an awful lot on sheer luck, as basic engineering principles are consciously ignored when a cantilever bridge is constructed. Too many cantilever bridges tend to break and fall off like icicles in the spring thaw. > Consider an implant. > -- > W_B Good idea. Either that or a 3-unit bridge, assuming the posterior tooth meets abutment criteria. - dentaldoc > Too many cantilever bridges tend to break and fall off like icicles in > the spring thaw. Can you not to a cantilever/Maryland bridge, in which you have clasp like extensions on the buccal lingual as well as an occlusal rest? Thanks SP SignatureNot a real Addy, yet >> Too many cantilever bridges tend to break and fall off like icicles in >> the spring thaw. [quoted text clipped - 3 lines] > Thanks > SP Yes. That's what I decribed earlier. >> Too many cantilever bridges tend to break and fall off like icicles in >> the spring thaw. [quoted text clipped - 3 lines] >Thanks >SP If the clasp/rest/lingual whatever extensions are not *bonded* in place then the inevitable decay dooms the restoration to failure. Even a good metal/tooth bond eventually breaks loose. Cantilivered bridges, IMO, are just asking for trouble. If the pulpal health of one or both of the abutments is in question... endo. Longevity of the final restoration should be the prime concern. This is all theoretical since no radiographs nor pictures have been posted AFAIK. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>Hallo! >> [quoted text clipped - 22 lines] > > Consider an implant. He means an implant is not suited in that place. Too close to the sinus and not enough space (?). Thanks for your replies. cesco > -- > W_B > > wubbabubbazG@RBAGEyahoo.com > Take out the G'RBAGE >>>Hallo! >>> [quoted text clipped - 27 lines] > > cesco ...said an implant would be possible with a bone implant... that sounds complicated. >> -- >> W_B >> >> wubbabubbazG@RBAGEyahoo.com >> Take out the G'RBAGE I haven't found any good opinion about cantilever bridges. I guess I will try to get an implant if the anatomy aloows it. Might post an x-ray later. thank you for your help >>>>Hallo! >>>> [quoted text clipped - 38 lines] >>> wubbabubbazG@RBAGEyahoo.com >>> Take out the G'RBAGE >I haven't found any good opinion about cantilever bridges. >I guess I will try to get an implant if the anatomy aloows it. >Might post an x-ray later. > >thank you for your help The advice so far was excellent. Its about stress. Heavy bite versus lite bite, etc. Joel >>I haven't found any good opinion about cantilever bridges. > The advice so far was excellent. Maybe we weren't telling him what he wanted to hear? >> The advice so far was excellent. > >Maybe we weren't telling him what he wanted to hear? About cantilevers ........ Rock on! I *think* what he means by noone has a good opinion of cantilevers is that most dentists think they are risky at best. Not that 'good opinions' have not been offered. :-) Fawks >>>I haven't found any good opinion about cantilever bridges. > >>The advice so far was excellent. > > Maybe we weren't telling him what he wanted to hear? > I *think* what he means by noone has a good opinion of cantilevers > is that most dentists think they are risky at best. > > Not that 'good opinions' have not been offered. > > :-) Oh yeah. ;-) ok, I'll rephrase :-) I haven't found anyone advising me to get a cantilever bridge done. I hope I'll be able to have an implant... >> I *think* what he means by noone has a good opinion of cantilevers >> is that most dentists think they are risky at best. [quoted text clipped - 4 lines] > > Oh yeah. ;-) > ok, I'll rephrase :-) > > I haven't found anyone advising me to get a cantilever bridge done. > I hope I'll be able to have an implant... Thanks. I thought that was what you meant, but reading isn't always the same as writing. :-) Fawks >> ok, I'll rephrase :-) >> [quoted text clipped - 6 lines] >:-) >Fawks Or arithmetic... <8^]]> -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com "Steven Fawks" <tuthjockey@earthlink.net> wrote.............. > Thanks. I thought that was what you meant, but reading isn't always the > same as writing. > > :-) > Fawks Another usenet jewel!! carabelli - too bad Jan can't appreciate either end of this classic That's because it is possible to both read and write without comprehension! ;-) Fawks >>Thanks. I thought that was what you meant, but reading isn't always the >>same as writing. [quoted text clipped - 5 lines] > > carabelli - too bad Jan can't appreciate either end of this classic |
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