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Medical Forum / General / Dentistry / September 2005

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Implant or Bridge?

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jhatpro - 12 Sep 2005 18:55 GMT
I'm 63 and my dentist for the past 30 years is recommending I have a
removable bridge to replace #13, which was removed as the result of
vertical crack in the root which could not be repaired. He feels that,
for one tooth, this has advantages over an implant, which he says could
develop problems. What do you think?
Mark & Steven Bornfeld - 12 Sep 2005 18:59 GMT
> I'm 63 and my dentist for the past 30 years is recommending I have a
> removable bridge to replace #13, which was removed as the result of
> vertical crack in the root which could not be repaired. He feels that,
> for one tooth, this has advantages over an implant, which he says could
> develop problems. What do you think?

    What advantages?

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

jhatpro - 12 Sep 2005 19:18 GMT
Lower cost, for one, but mainly what he described as being "less
invasive." Also, he says several of his patients had trouble with
implants. In one case, the implant didn't integrate with the jawbone
properly and the tooth rotated in the socket. Not sure what the
difficulty was in the other case.

I've never had a bridge and am worried about fit, oral hygiene,
convenience, swallowing it, and having it somehow interfere with my
trumpet playing.

Thanks for any advice you can give.
Mark & Steven Bornfeld - 12 Sep 2005 19:39 GMT
> Lower cost, for one, but mainly what he described as being "less
> invasive." Also, he says several of his patients had trouble with
[quoted text clipped - 7 lines]
>
> Thanks for any advice you can give.

    Removable partials to replace one tooth (except for an all-acrylic with
a palate) are generally considered a poor idea.  I've seen them work,
but they put some fairly strong forces on the adjacent teeth, and
swallowing is a risk for the so-called Nesbit appliances, esp. if
patients wear them to sleep (usually a bad idea for partials in any case).
    A fixed bridge may be an acceptable option esp. if the adjacent teeth
are periodontally healthy and relatively broken down, since the crowns
that hold the false tooth in place can be seen as strengthening those
teeth.  However, if those surrounding teeth aren't periodontally healthy
they are a poor risk for holding a bridge; and grinding down intact
teeth to hold a bridge is rather invasive itself.
    Yes, some implants fail, but at this point they are mostly highly
predictable.  Upper premolar area implants not infrequently require bone
grafting, and sometimes what is called a "sinus lift".  This may be what
your dentist is referring to when he says it can be invasive.  All these
issues must be looked into when deciding which way to go.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Joel M. Eichen - 12 Sep 2005 20:48 GMT
Removable for one tooth = "Nesbitt."

>> Lower cost, for one, but mainly what he described as being "less
>> invasive." Also, he says several of his patients had trouble with
[quoted text clipped - 26 lines]
>
>Steve
W_B - 13 Sep 2005 17:36 GMT
>    Removable partials to replace one tooth (except for an all-acrylic with
>a palate) are generally considered a poor idea.  

I think he's talking about an FPD.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
jwn dds - 12 Sep 2005 20:05 GMT
I'm sorry but the whole "less invasive" thing is troubling me.  Bridges are
far more invasive in my books than an implant.  Prepping 2+ teeth to replace
a missing one is asking for trouble down the road.  An implant is superior
in everyway except for short-term cost.  I say short-term because years from
now when your bridge falls apart and is replaced you will end up paying more
than if you originally placed an implant.

jwn dds

> Lower cost, for one, but mainly what he described as being "less
> invasive." Also, he says several of his patients had trouble with
[quoted text clipped - 7 lines]
>
> Thanks for any advice you can give.
jhatpro - 12 Sep 2005 20:18 GMT
Thanks. Guess I better talk to my dentist. He's provided wonderful care
over the years, but maybe it's time to get a second opinion. What
you're telling me is fully supported by the opinion of several friends
who've had implants and are very happy with them.
Joel M. Eichen - 12 Sep 2005 20:49 GMT
>Thanks. Guess I better talk to my dentist. He's provided wonderful care
>over the years, but maybe it's time to get a second opinion. What
>you're telling me is fully supported by the opinion of several friends
>who've had implants and are very happy with them.

Your dentist needs to join sci.med.dentistry!

Joel

(Trollin' for new people).
Steven Fawks - 13 Sep 2005 17:46 GMT
Bridges often make sense if the teeth on either side of the missing
tooth need crowns anyway.  If the teeth on either side of the gap
are perfect (or almost), then the implant would be considered more
conservative (assuming there is enough bone without grafting).

One other disadvantage of implants is the time it takes to actually
be finished with the treatment.  It isn't unusual to allow 6 months for
osseous integration after placement of the implant body.  By contrast, a
bridge can be finished in a couple of weeks.

It is very difficult to predict longevity of one restoration over
another.  The first bridge that I made in private practice is
26 years old and doing fine.  My oldest implant case is 'only'
15 years old.

One thing is for sure, an implant will not decay.

:-)
Fawks

> I'm sorry but the whole "less invasive" thing is troubling me.  Bridges are
> far more invasive in my books than an implant.  Prepping 2+ teeth to replace
[quoted text clipped - 16 lines]
>>
>>Thanks for any advice you can give.
W_B - 13 Sep 2005 17:36 GMT
>> I'm 63 and my dentist for the past 30 years is recommending I have a
>> removable bridge to replace #13, which was removed as the result of
[quoted text clipped - 5 lines]
>
>Steve

How about lack of need for surgery, and shorter treatment time ?
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Joel M. Eichen - 12 Sep 2005 20:48 GMT
>I'm 63 and my dentist for the past 30 years is recommending I have a
>removable bridge to replace #13, which was removed as the result of
>vertical crack in the root which could not be repaired.

If he is been recommending it for thirty years, may I suggest a Dale
Carnegie course for him?

Joel

> He feels that,
>for one tooth, this has advantages over an implant, which he says could
>develop problems. What do you think?

I say 30 years is time enough to learn better .......

Joel
 
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