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Medical Forum / General / Dentistry / April 2006Implant vs. bridge
I am about to do an implant on #8 (upper molar). I've read up way back on this newsgroup about pros and cons. What makes my case different is that I am also simultaneously redoing the existing crowns #7 and #9, so a bridge would not be an invasive option. My prosthodontist and oral surgeon recomment an implant; but I get a feeling they always do. Should I at least consider a bridge instead? Would an implant save me money, long term? And if it does, one would expect insurance companies to want to pay for implants, just like they want to pay for other measures that save them money over the long run, no? I mean, if it's so good, why don't they cover at least $300 or something towards an implant, the price they would be forced to cover anyway if the patient chooses the bridge option? Sounds like good business to me. Thanks to all the wonderful dentists there, I am very appreciative of your time. > I am about to do an implant on #8 (upper molar). I've read up way back > on this newsgroup about pros and cons. What makes my case different is [quoted text clipped - 13 lines] > Thanks to all the wonderful dentists there, I am very appreciative of > your time. There is no one right answer. An implant is better in that the restoration is self-supporting, and flossing can be done in the conventional way. But the major selling point is often that the surrounding teeth don't need to be prepared, and this isn't an issue here. Furthermore, you already state that crowns on #7 and #9 are being replaced anyway. If they are in good shape periodontally the only other reason to do the implant is that it is likely to preserve the bony ridge--the loss of which can occasionally cause cosmetic problems if you have a high lip line and show a lot of tooth when you smile. Selling an implant based on the hypothetical loss of #7 and 9 is really self-serving of the surgeon. If #7 and 9 aren't in good shape periodontally it's a completely different story. But in your case I would have a hard time justifying an implant. JMO, Steve > > I am about to do an implant on #8 (upper molar). I've read up way back > > on this newsgroup about pros and cons. What makes my case different is [quoted text clipped - 28 lines] > different story. But in your case I would have a hard time justifying > an implant. Plus, if a bridge has been there for a while, then an oral surgeon may have to do a bone graft before the implant. > Plus, if a bridge has been there for a while, then an oral surgeon may > have to do a bone graft before the implant. Good point--if the decision is made at a later date to do an implant, it is more likely that a bone graft will be necessary. It doesn't mean a bone graft won't be necessary even if the implant is done immediately, but it will be less likely. Even so, it wouldn't be a decisive factor for me. Steve >> Plus, if a bridge has been there for a while, then an oral surgeon may >> have to do a bone graft before the implant. [quoted text clipped - 6 lines] > > Steve Out of curiosity, what all is involved with a bone graft? I'm going to need one when my braces are finished (whole reason why I'm doing this in the first place, because I'm losing bone where I don't have a permanent tooth)--I've done a web search but really can't find a simplified explanation. How much pain is involved? Is it oral surgery that takes awhile, or something else? TIA, Carolyne in TX >>> Plus, if a bridge has been there for a while, then an oral surgeon >>> may have to do a bone graft before the implant. [quoted text clipped - 16 lines] > TIA, > Carolyne in TX It is surgery. However, often it is done at the time of extraction, so the additional pain from the grafting procedure probably isn't much. The only reason I'm waffling in my answer is that it depends upon how large an area needs to be grafted, and how much gum tissue needs to be reflected to place it. Most of the time grafting is done with exogenous materials--IOW, the bone is not harvested from your own body. If the bone has to be harvested from your jaw, you of course have that additional surgical site, which I hear usually winds up hurting more than the recipient site--this is probably the biggest reason other materials (freeze-dried bone, fake bone) are used. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>>> Plus, if a bridge has been there for a while, then an oral surgeon >>>> may have to do a bone graft before the implant. [quoted text clipped - 30 lines] > > Steve It's a small site, just the place where I should have had a permanent tooth (but was born without)--I'm planning to get an implant because a bridge would not help encourage new bone growth (or so I've been told). Since the 2 surrounding teeth are leaning over, I've needed to get them straightened with the braces first. Is it true they use harvested cadaver bone? What kind of dangers are possible with that? I remember reading about some illegal harvesting done awhile back (Alistair Cooke and others) and that disease testing wasn't done in many of those cases, does the dentist just assume the material to be grafted is of pure quality? I'm not against using cadaver tissue (my late sister had a life saving kidney transplant from a cadaver years ago), but I sure don't want to take unnecessary chances on catching something really bad if this is an unmonitored type of procedure! >>>>> Plus, if a bridge has been there for a while, then an oral surgeon >>>>> may have to do a bone graft before the implant. [quoted text clipped - 48 lines] > take unnecessary chances on catching something really bad if this is > an unmonitored type of procedure! I've heard of using cadaver bone. I don't actually know what most of the surgeons are using--again it would be good if surgeon Dave would chime in. My wife had a bone graft with a mixture of demineralized freeze-dried cow bone and fake bone. I guess then there's always the issue of Mad Cow, but she's no madder than before, and she'd doing great with the implant. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >How much pain is involved? In my case, it was done under general anaesthetic as the block of bone came from my hip. To be honest, the receipient site wasn't painful at all, and I hardly used any pain killers (ibuprofen). The donor site was more sore for a few weeks, particularly to touch, but not really uncomfortably so. >>How much pain is involved? > [quoted text clipped - 3 lines] > more sore for a few weeks, particularly to touch, but not really > uncomfortably so. Your experience is typical in that the donor site was more sore. Perhaps not so typical in that a large block of bone needed to be harvested. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I vote for bridge .... Joely abc Wrote: > I am about to do an implant on #8 (upper molar). I've read up way back > on this newsgroup about pros and cons. What makes my case different is [quoted text clipped - 14 lines] > Thanks to all the wonderful dentists there, I am very appreciative of > your time -- Joel34 |
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