Re: Rebuilding Crowned Lateral Incisor with 4 unit bridge

Wilson wrote:

Mark & Steven & Alex:

I like his approach of a bridge across #9 through #12, because it fills
in the gap of missing #10 and #11.
I am not as comfortable with the implant because of the 6 months to get
this fixed, and the amount of pain involved.

Yes, crowning four teeth was aggressive. But 17 years ago the Internet
did not exist, so it was much more difficult to learn about all of the
options. (It's really hard to even remember what it was like before
the Internet, isn't it?) At the time, I *thought* that I was getting
porcelean veneers, but what he installed were crowns.

I don't see it as (more) complex to remove an existing central incisor
crown and replace this with a four-unit bridge. I sort of know what to
expect with this procedure. The implant is more of an unknown (to me).

I'm not sure how long-lasting the bridge (in this location) would be
vs. an implant. Is the additional pain/cost/time of an implant really
worth it? It is hard for me to judge.

What would be the "impact" of the possibly impacted teeth to this?
Could they preclude the implant or have to be removed first?

Also, how "thick" are the teeth in a bridge compared to normal/crowned
teeth? Will they seem "natural" to my tongue?


Thanks,

If the teeth are adequately prepared, they should have pretty normal contours. Yes, depending upon the location of any impacted teeth, placement of implants in this area may not be possible without removal.
I understand your motivations, and your plan may well give the best cosmetic result. You will see figures bandied about concerning how long a bridge will last vs. an implant--I personally wouldn't worry about the statistics out there. I have a patient with 60-year old bridges still serving (not pretty, but they work).
I would generally assume any dentist would check for impacted canines. Statistically, lateral incisors are more frequently missing, and canines more frequently impacted. But as I said, these are just statistics.
Make sure you understand what is planned, and it's always a good idea to get a second opinion with complex treatment plans like this.

Good luck,
Steve


--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

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