Re: Rebuilding Crowned Lateral Incisor with 4 unit bridge

Wilson

You're trying to play dentist on your own and the fact is you are
missing a lot of important information which will lead you to make a
bad decision.
Implant surgery in not very painful at all.
Now if everything is good as far as bone you only need to wait 3 months
and there are things you can do to such that during the healing process
you still have a tooth there.
For example there is immediate placement and loading which is becoming
to be more successful. There are also many ways to make a temporary
tooth to fill the space during healing.
You said
"Is the additional pain/cost/time of an implant really worth it? It is
hard for me to judge."
I would have to say yes. If you get decay under one of those crowns you
are going to have to replace the whole bridge, risk more drilling of
your teeth and more chance of something needing a root canal.
Also by avoiding the bridge you will be able to floss like you do with
natural teeth, a bridge needs an extra tool called a floss threader to
maintain flossing.
And if you don't floss now or barely floss imagine what it would be
like when the floss threader is not around.
Again you suggestion for a bridge is connecting incisors to posterior
teeth, the current philosophy is begining to change advising this
should be avoided.
As far as closing gaps, you are not an expert on the best way to do
this and there are many other ways maybe less expensive and better than
what you are proposing.
There is a saying "Anyone who tries to be their own doctor has an idiot
for a patient.", you do not want to be an idiot. Leave the treatment
planing to the professionals. That does not mean you should not
participate in it, you need to express your concerns ask all the right
questions, reveal all your habits and go through different treatment
options. But don't try to play dentist by thinking something is going
to be better and look nicer than something else, you do not know and
you have not seen what everything looks like to make that decision
yourself.
Good Luck.



Mark & Steven Bornfeld wrote:
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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