I had a bridge replacing four front teeth. The bridge was anchored by the canine teeth. Now the canine teeth have come loose. I went back to the clinic where I had the dental bridge done and they suggested a partial denture to replace all those teeth (including the canines) and then another for a missing lower molar. I have found the partial to be incredibly uncomfortable. Now they’re suggesting using mini implants to replace the upper teeth. I decided to get a second opinion. This doctor had a vastly different treatment plan. He wants to do a bridge on the lower molar because he said one of the adjacent teeth needs a crown anyway. Then he wants to place three regular-sized dental implants one where each of my canine teeth were and a third directly between them. When that’s done he will attach another bridge to the implants. His plan is considerably more expensive. I’m totally confused as to which is right and am trying to not just let the price difference dictate my decision. Do you care to be the tie-breaker?
Bruce
Dear Bruce,
Right up front I am going to tell you that the second plan is by far superior, but I want you to understand why. Let’s start with the mini implants the first dentist is suggesting. These are not meant to support individual teeth, including dental crowns. They don’t have the necessary strength. Instead, they can sometimes be used to help stabilize a denture, but even then, they won’t be as strong as traditional dental implants.
At some point, likely sooner rather than later, these mini-implants will fail. Then what will you do? When dental implants fail, they take bone structure with them. In order to have new implants placed, that bone structure will have to be filled back in. Now you’re talking about needing bone grafting surgery even before you can have the surgery to replace the mini implants. All for a procedure that will likely fail again.
Your second dentist’s recommendation has solid engineering principles behind it. I want you to peek at this picture below.
The way your previous bridge was designed, it put the abutment teeth (the anchors for the bridge) on your canines. There are a lot of twisting forces in this position involved when we bite or chew. It wouldn’t surprise me at all to learn that it didn’t take long for the abutment teeth to come loose, which is why you are now losing them.
Full-sized dental implants can support a single tooth, so replacing those canines with them is a fantastic solution. But, wouldn’t attaching another bridge to them have the same problem as your previous bridge? Yes, except, the second dentist is suggesting a third implant directly between them to help stabilize things. This will prevent that twisting motion, enabling the implants for your bridge to remain secure, possibly for the remainder of your lifetime.
Go with the second dentist. He has a much better understanding of dental implants, tooth structure, and biting forces.
This blog is brought to you by Duluth, GA Dentist Dr. David Marion.