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Re: bridge or implants

Posted by cs on 10/23/2009, 9:12 am, in reply to "bridge or implants"

<< . . . has anyone had implants done in the front after wearing a bridge for about 17 years? >. Not quite. But in 2003, I did receive an implant after having a post and crown on a top, front incisor for 25 years. To be honest, although my problem was unanticipated and described as needing immediate attention, for which the first dentist I consulted recommended a bridge (with no mention of an implant), I did not consider his recommendation for even a second. Having researched implants on behalf of a customer when they were first being introduced to the U.S. market( in the late '80s), I had felt then (and still do) that they are a better choice — although since landing on this website in search of answers during those stress-filled days, I have to admit that I have softened my position a little. I now agree that for some patients, a bridge might be just as good a choice — depending on their goals and expectations for replacing one or more missing teeth. For the purpose of comparison, I can tell you that while I was fortunate that my former dentist (25 years earlier) was able to rescue my fractured incisor (#9), he also informed me that due to the severity of the damage, which also had affected the surrounding bone, there was a good chance I would develop a "long tooth," over time. Basically, it meant that in order to protect the remnant of the natural tooth, he had to order an extra long crown that extended far above the gum line. As a result, there was a risk that future gum recession (if it occurred) might make the visible portion of the crown look overly long compared to the neighboring teeth. In fact, that's what happened — which in a sense, probably is comparable to a bridge with poor margins. From what I've read, it's also the reason some dentists recommend against implants. (i.e., because they are concerned that any future gum recession might create a space between the gum and (natural) top of the implant crown.) Getting back to my case, although I did choose against a bridge (from #6 to #10), I accepted my implant dentist's recommendation to crown three of the same four teeth adjacent to the implant — both because tooth #7 had just lost an old crown that had to be replaced any way — but also, because even though they didn't need immediate attention, it looked like either restoration . . . cosmetic work (or both) were in the cards for both #8 and #10. Taking care of them all at the same time proactively made sense, because it assured a perfect match. In other words, I opted for individual crowns on all three — which in essence, was similar to a bridge; just not fused together. The bottom line: Post op swelling immediately after the work was done made my gum line look fantastic. For the first time in 25 years, the gum tissue fit snugly against all four crowns. But as the swelling gradually receded, my gum slowly did creep upward, creating a tiny but visible gap. To his credit, my dentist worked valiantly to correct it — both manually in the office, and by returning the crowns to the lab for further fine tuning. Each time the result looked perfect at first, but gradually the gum crept back up. After several attempts, he finally decided the site just needed more time for further healing and recommended that we proceed with the remaining "catch-up" work on my treatment plan — promising to revisit the problem after the gum had settled down permanently. Somewhere between 18-24 months later, he informed me the time had arrived. In the interim, advances in dental treatment (e.g., the introduction and assorted uses of zirconium) had made a few new options available.) The result was as near-perfect as anyone could expect — considering the starting point of the project. The gum above the #9 is only a hair higher than that of #8, and really not visible at all, due to my low lip line. During the waiting period, not only were the aging crowns and fillings on several old teeth updated or replaced, but in conjunction with ortho to realign the age-related crowding of my lower front teeth (which had contributed to the loss of #9), my entire smile was broadened via Invisalign. The result of all this work certainly has been worthwhile. Although I had never been particularly unhappy about my smile before, even I am impressed — as were my family and friends when they first saw it. (Also forgot to mention — though I wish it were otherwise — I no longer am a spring chicken. Our oldest son celebrated a milestone birthday this week (his 40th!) While I attribute most of my "metamorphisis" to my dentist, his hygienist also deserves much of the credit. It was she who taught me step-by-step the many things that had been overlooked in my grade school classes in dental hygiene (e.g. including basics such as how to brush and floss properly). Whoever said you can't teach an old dog new tricks was wrong! Although they've always been relatively healthy, my teeth and gums have never been in better condition. I mention that because whether you decide on a bridge or implant, home care is going to be essential to the success of your dental work. Good luck with whatever path you choose to follow. PS: I forgot to mention: Your choice of a dentist is critical to the outcome of your dental work. Regardless of the title or type of dental specialty your dentist uses to identify him/herself, be sure to choose someone who not only is experienced in the type of work you decide on (i.e., bridge or implant) — but also one with whom you feel at ease when it comes to communication.

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Responses: Re: bridge or implants - jackie to cs 10/24/2009, 10:03 am Re: bridge or implants - CS 10/25/2009, 6:44 am Re: bridge or implants - jackie 10/25/2009, 9:18 am Re: bridge or implants - cs 10/25/2009, 6:20 pm Re: bridge or implants - carol 11/15/2009, 9:01 pm « Back to thread

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