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Medical Forum / General / Dentistry / May 2007replacing a bridge
Visited the dentist last week, discovered that my bridge (across #13) has a leak... a gap has opened at #12, and that tooth has decayed. How far gone, as yet unknown, they need to remove the bridge to get a peek. Now my question is: is the bridge salvageable, normally, in a case like this? She spoke of sawing it in half. ick When it was installed, 10 years ago, I recall the dentist saying he used a 'temporary glue' (whatever that is), and would redo the procedure with permanent glue later, after I had worn the device, to test for fit. He said he would bang it out with a hammer. The fit was good (at that time), I never returned for thet rework. So, is the hammer job still feasible? Mark > Visited the dentist last week, discovered that my bridge > (across #13) has a leak... a gap has opened at #12, and [quoted text clipped - 14 lines] > > Mark Possibly, but far less likely it's worth saving the bridge. The decay occurs at the margin, and so the crown on the decayed tooth no longer seals. With small accessible cavities at the gumline on the cheek or tongue side it's sometimes possible to patch the area, but large cavities esp. between the teeth are difficult or impossible to seal effectively. Steve > > Visited the dentist last week, discovered that my bridge > > (across #13) has a leak... a gap has opened at #12, and [quoted text clipped - 21 lines] > but large cavities esp. between the teeth are difficult > or impossible to seal effectively. Sounds grim. I was thinking that the working side, where the bridge meshes with the lower teeth, would still be useable, yes/no? That part hasn't suffered any damage, or alteration, so should be recycleable... a fresh bridge is a big financial hit... Mark Sorry,,,,,,,,,,,, the entire restoration would *probably* need to be made over again.  Signature/ Amatus / >> > Visited the dentist last week, discovered that my bridge >> > (across #13) has a leak... a gap has opened at #12, and [quoted text clipped - 31 lines] > > Mark >>> Visited the dentist last week, discovered that my bridge >>> (across #13) has a leak... a gap has opened at #12, and [quoted text clipped - 27 lines] > > Mark The other crown may be salvageable; but this won't help if the aim is to have a bridge. If it turns out the decayed tooth is non-restorable, it may be possible to retain the crown on the tooth that isn't decayed. But then you're faced with the issue of replacing the 2 missing teeth (the original false tooth from the bridge plus the decayed tooth if it's lost). There is something to be said for doing this with implants if possible, but this is likely to be more expensive than a new fixed bridge. If there are missing teeth on the other side of the same jaw a removable appliance can be considered--this may be less expensive, and sometimes quite satisfactory. Steve >>>> Visited the dentist last week, discovered that my bridge >>>> (across #13) has a leak... a gap has opened at #12, and [quoted text clipped - 40 lines] > >Steve Did one case many years ago that salvaged the posterior retainer and pontic, then had a new anterior retainer and pontic made that was soldered to the posterior piece. Went from a 3 X 5 to a 3 XX 6. Pick-up impression with impression for new retainer (6) temp bond in posterior retainer for impression. It worked and fit well, a good impression gave a good result. Note I said *one* case, many years ago. Wouldn't have done it then if the patient wasn't in their 80's. Would not even consider such treatment now. My 2¢ It's a bad idea, hard to make work, and at best is a crappy compromise. >If there are missing teeth on the other side of the same jaw a >removable appliance can be considered--this may be less expensive, and >sometimes quite satisfactory. > >Steve Agreed but, if made well an RPD can be *almost always* Very sastisfactory ! If you need the name of a good lab contact me privately. wubbabubbazG@RBAGEyahoo >> If there are missing teeth on the other side of the same jaw a >> removable appliance can be considered--this may be less expensive, and [quoted text clipped - 7 lines] > > wubbabubbazG@RBAGEyahoo I'm in good shape there. I'm not thrilled with unilateral partials, but usually even these are well-tolerated. I have a patient who kinda pushes the envelope though--her only remaining tooth is #15, and she has an acrylic-base partial with a clasp on it. Hanging onto that tooth for dear life. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>> If there are missing teeth on the other side of the same jaw a >>> removable appliance can be considered--this may be less expensive, and [quoted text clipped - 5 lines] >> >> If you need the name of a good lab contact me privately. > I'm in good shape there. I'm not thrilled with unilateral partials, >but usually even these are well-tolerated. I have a patient who kinda [quoted text clipped - 3 lines] > >Steve Ok. Unilateral partials ? Nesbit appliances ? I don't and never have made one. > Ok. Unilateral partials ? Nesbit appliances ? > I don't and never have made one. No, not Nesbits. A partial where all teeth replaced are unilateral (using a major connector and some attachment to teeth on the other side of the arch. For a couple of teeth, patients sometimes complain it's a lot of hardware. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Ok. Unilateral partials ? Nesbit appliances ? >> I don't and never have made one. [quoted text clipped - 5 lines] > >Steve Kennedy Class II If designed well with proper rest seats and clasping, these can be made quite functional and comfortable. The trick is the anterior rest on the opposite cuspid. Use a T-bar on the edentulous side; double T's can also be used. If the contralateral side is not missing any teeth use an embrasure clasp. Good preparation is key. >>> Ok. Unilateral partials ? Nesbit appliances ? >>> I don't and never have made one. [quoted text clipped - 15 lines] > teeth use an embrasure clasp. > Good preparation is key. I agree. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Visited the dentist last week, discovered that my bridge > (across #13) has a leak... a gap has opened at #12, and [quoted text clipped - 14 lines] > > Mark Is this a "Mark" I know from smd history? Webby Hindsight is often clearer than foresight. Not to beat you up because what is done, is done. Maybe someone else can learn from your troubles. The big mistake was not having the restoration properly cemented after the trial period. This allowed the temporary cement to loosen on one tooth, leak fluids, debri, bacteria underneath, and then to decay and failure of the restoration. Might need endo. The whole tooth may even be unsalvagable. Saving the existing bridge would be a long shot. Though not commmon, this can happen even when bridges are properly cemented. Each checkup should include close examination of all crowns and bridges for leakage or loosening. JMO, D > Visited the dentist last week, discovered that my bridge > (across #13) has a leak... a gap has opened at #12, and [quoted text clipped - 14 lines] > > Mark |
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