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I've been given the option of replacing the tooth with a bridge or with an implant.
Any recommendations?
Thanks, CaTe
Assuming you're qualified for both the implant and the bridge and they both have a good long-term outlook, some of the decision-making factors are:
1. How old are you? Implants are preferred for younger people because the tooth has to last longer. Bridges can have a lifespan similar to implants, but since they alter adjacent teeth, it can cause problems for those teeth as well. Thus, it's better not to mess with teeth that don't need to. If you're older, then you may not need to replace the tooth or need to replace it only once. So a bridge in this case isn't so bad.
2. Esthetics. Implants can provide excellent esthetics, but they can also provide extremely poor esthetics, especially in the front. If you bone and, especially, the gums maintain excellent architecture, then you'll be hard-pressed to know it's an implant. However, when the bone is resorbed or the gums shrink, you'll easily spot the implant.
3. Hygiene. The #1 cause of failure of implants is gum-disease. Implants require extremely good hygiene. Bridges also require good hygiene, but are less sensitive than implants. Bridges do require better hygiene than natural teeth, though.
4. Health status. Implants are contra-indicated in people with poor gums, smokers, diabetics, people taking osteoporosis medications, etc. Some disqualifiers are changing, such as smoking. In these cases, healing is retarded so the implant may not hold.
5. Other criteria have been mentioned below. This list is not exhaustive.
Quote:
Originally Posted by BLAZER PROPHET
Implant-it is something I would never recommend having done by a general dentist- only by an Oral Surgeon or other specialist as so much can go wrong. Bridge- If the bridge is not very well made (suggest a prostodontist) you will have problems with the abuttment teeth, that will usually lead to root canals and eventually loss of teeth. I would perfer an implant myself. The success rate is over 90%- and that's pretty good.
You can have an implant placed by specialists (oral surgeon, periodontist, or prosthodontist) or by a general dentist. Bridges can be made by either a prosthodontist or general dentist. Should you see one versus the other? It depends on who it is you're seeing. Some general dentists are excellent at implants, while some oral surgeons are horrible at it. It really depends on how much training and experience they've had, and you can't tell by the diploma on the wall. On average, the periodontist will have placed the most implants though. They're also gum specialists so they tend to pay attention to the fine details of gum esthetics.
Implant success rates are very good. But so are bridges. For me and my family, I'd choose implants.
Quote:
Originally Posted by beanandpumpkin
I will add that if the adjoining teeth are untouched, or only have a small filling, I'd go with the implant. If they have large fillings and/or root canals, I'd probably go with the bridge, because those adjoining teeth will likely need crowns at some point anyway.
This is a good point. The only caveat is that if BOTH adjacent teeth have root canals, you have to be careful that they're not so weak that a bridge can't be supported.
Quote:
Originally Posted by Fat Freddy
I thought about implants, but my my bone was too narrow so I got a bridge with two teeth on it. The teeth it was mounted to were worn and cracked and needed crowns anyway as did several others so I had my whole mouth done, including a new partial for the bottom.
Another alternative is to place implants in select spots and have an implant-supported partial denture. Depending on the partial denture it can provide both stability and retention.
Quote:
Originally Posted by from PA
I have a roundhouse bridge that is approx 5 years old. Last year I had a root canal through the the first molar on one side. Subsequently, the porcelin broke off and now it looks like I'm missing that tooth. What is the success rate of these bonding procedures?
Replacing the bridge is not an option. It involves 12 teeth.
I'm not sure what the success rate of bonding procedures are. There are two ways to fix porcelain chips (besides replacing the whole thing). First, you can bond a white filling onto the material. The other is that you can make a veneer and glue it onto the crown. The most important question to figure out is why the porcelain chipped in the first place. It is probably not because of the root canal procedure. The most common cause is that the porcelain is too thin. A bonding or veneer won't fix that. You would need a new crown to create a thicker porcelain layer.
Quote:
Originally Posted by katzenfreund
Implants are a better and long lasting choice, IF you get a specialist to do the procedure and you are a good candidate.
Implants are not necessarily longer-lasting than bridges. Did you know some bridges are 50 years old? Can you find an implant that old? You'd be hard-pressed to find research that pinpoints the life-span of implants, but it's enough to say that both options have merit and are long-lasting solutions (though not permanent. Nothing except your own tooth is permanent.). Some implants are not as complicated as you think. The right general dentist is more than qualified to place implants. Generally, the more implants placed, or the more complicated the situation, the better the dentist or specialist must be. Front teeth also require special care. There are several general dentists I would let place implants in my mouth.
Quote:
Originally Posted by katzenfreund
One more thing... is this a front tooth? You mentioned it shows when you smile...
You might also want to look into something called a "Maryland bridge". The fake tooth is attached to the neighboring teeth, WITHOUT getting crowned. This is also cheaper and some people have good success with this.
Maryland bridges have fallen out of favor. You are correct that the adjacent teeth are not cut. However, because of that you rely on cement to hold the bridge in place. The problem comes when one cement bond breaks, while the other holds. It's enough to keep the bridge in place and you don't know the bridge is failing. Meanwhile food and debris get under the broken cement seal and cause cavities. Maryland bridges have a lower average life span as well.
Quote:
Originally Posted by gardener34
I would go for the implant. It's like a real tooth.
The implant is very, very close to your own tooth. The biggest difference is that it doesn't move. Believe it or not, your natural teeth move, but you can't tell. They have slight "give" so that your bite is cushioned. Not so for an implant.
Quote:
Originally Posted by Lindsey_Mcfarren
I know a partial would annoy me no end.
Hardly anyone under the age of 999 wants a partial denture. That's not a typo on the age!
Sorry for the long post. Just wanted to clarify some points.
Assuming you're qualified for both the implant and the bridge and they both have a good long-term outlook, some of the decision-making factors are:
1. How old are you? Implants are preferred for younger people because the tooth has to last longer. Bridges can have a lifespan similar to implants, but since they alter adjacent teeth, it can cause problems for those teeth as well. Thus, it's better not to mess with teeth that don't need to. If you're older, then you may not need to replace the tooth or need to replace it only once. So a bridge in this case isn't so bad.
2. Esthetics. Implants can provide excellent esthetics, but they can also provide extremely poor esthetics, especially in the front. If you bone and, especially, the gums maintain excellent architecture, then you'll be hard-pressed to know it's an implant. However, when the bone is resorbed or the gums shrink, you'll easily spot the implant.
3. Hygiene. The #1 cause of failure of implants is gum-disease. Implants require extremely good hygiene. Bridges also require good hygiene, but are less sensitive than implants. Bridges do require better hygiene than natural teeth, though.
4. Health status. Implants are contra-indicated in people with poor gums, smokers, diabetics, people taking osteoporosis medications, etc. Some disqualifiers are changing, such as smoking. In these cases, healing is retarded so the implant may not hold.
5. Other criteria have been mentioned below. This list is not exhaustive.
You can have an implant placed by specialists (oral surgeon, periodontist, or prosthodontist) or by a general dentist. Bridges can be made by either a prosthodontist or general dentist. Should you see one versus the other? It depends on who it is you're seeing. Some general dentists are excellent at implants, while some oral surgeons are horrible at it. It really depends on how much training and experience they've had, and you can't tell by the diploma on the wall. On average, the periodontist will have placed the most implants though. They're also gum specialists so they tend to pay attention to the fine details of gum esthetics.
Implant success rates are very good. But so are bridges. For me and my family, I'd choose implants.
This is a good point. The only caveat is that if BOTH adjacent teeth have root canals, you have to be careful that they're not so weak that a bridge can't be supported.
Another alternative is to place implants in select spots and have an implant-supported partial denture. Depending on the partial denture it can provide both stability and retention.
I'm not sure what the success rate of bonding procedures are. There are two ways to fix porcelain chips (besides replacing the whole thing). First, you can bond a white filling onto the material. The other is that you can make a veneer and glue it onto the crown. The most important question to figure out is why the porcelain chipped in the first place. It is probably not because of the root canal procedure. The most common cause is that the porcelain is too thin. A bonding or veneer won't fix that. You would need a new crown to create a thicker porcelain layer.
Implants are not necessarily longer-lasting than bridges. Did you know some bridges are 50 years old? Can you find an implant that old? You'd be hard-pressed to find research that pinpoints the life-span of implants, but it's enough to say that both options have merit and are long-lasting solutions (though not permanent. Nothing except your own tooth is permanent.). Some implants are not as complicated as you think. The right general dentist is more than qualified to place implants. Generally, the more implants placed, or the more complicated the situation, the better the dentist or specialist must be. Front teeth also require special care. There are several general dentists I would let place implants in my mouth.
Maryland bridges have fallen out of favor. You are correct that the adjacent teeth are not cut. However, because of that you rely on cement to hold the bridge in place. The problem comes when one cement bond breaks, while the other holds. It's enough to keep the bridge in place and you don't know the bridge is failing. Meanwhile food and debris get under the broken cement seal and cause cavities. Maryland bridges have a lower average life span as well.
The implant is very, very close to your own tooth. The biggest difference is that it doesn't move. Believe it or not, your natural teeth move, but you can't tell. They have slight "give" so that your bite is cushioned. Not so for an implant.
Hardly anyone under the age of 999 wants a partial denture. That's not a typo on the age!
Sorry for the long post. Just wanted to clarify some points.
I tried to give you a rep point, but it said I need to spread the love. Anyone who wants two root canals deserves points... or should be committed.
Okay. So you owe me one! After a while, it's a cake walk for me. Except the last one where the darn root was waaay behind a filling. It already was done once, and then the local endo had to redo it...3 hours and some later, he finally found the last one. Hate the smell of guttapercha. I take my hat off to that endo...a true perfectionist and a pro! He has my business forever.
I've been given the option of replacing the tooth with a bridge or with an implant.
The implant will be a 5 month process and during that time, my missing tooth will be exposed when I smile. Also, the implant procedure is a surgical one versus the bridge which is not.
The bridge is quick and easy.
The cost is slightly higher for the implant, but not much more.
I'm opting for the bridge.
Any recommendations?
Thanks, CaTe
I have both and I'll take the implant any day. They have temporaries that you can wear while the bone is healing. They aren't comfortable and I know it's a long wait, but it's worth it.
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I have a tooth that requires extraction.
