6-unit fixed bridge v. implant supported bridge

Last January I went to a dentist have my crowned tooth # 7 reattached, as it had broken off (at least 4 times in past 10 years). Unfortunately,  there was very little root left to attach a post. There was also significant bone loss for crowned teeth # 7, 8, 9 & 10. The dentist told be that they should all be pulled and be replaced with implants and new crowns after I had bone grafting performed.

As I am a 1 pack a day smoker I explained to the dentist that I would rather have a 6-unit fixed bridge rather than spend $20,000 + for implants that have an increased failure rate for smokers. He sent my impressions out for review and on my next appointment he told me that the span was too long for a bridge and that I really should have the implants installed or consider removable dentures. As I was only 45 yrs. old I decided to go with the 4 dental implants & 4 crowns.

I had the crowns/roots removed & bone grafting done in March 2008 and this past January had the surgical guide and molds made for preparation on the implants being installed. However 7 days before my implant surgery, my dentist called me into his office and casually stated that I did not have room for 4 implants so the plan is to now install 2 implants on a fixed bridge. He also stated that I needed to have both my canine teeth done (one is real,the other is a crown) in order to attach a temporary bridge while my implants are healing (since last March, I have had a flipper which has worked fine).

Needless to say, I am very upset with my dentist & oral surgeon, as it would see to me that it was very poor planning on their part in the very beginning of this whole thing. When I explained to the dentist that I had concerns about 2 implants supporting a bridge and one of the implants failing, making the bridge a complete failure, he told me I was wrong. When I told him that I was going to get a 2nd opinion from an prorthodontist he got extremely angry and down right verbally abusive.

I did consult with a prorthodontist and he stated that I could have three implants to support the bridge. However, at this point I just want a 6-unit bridge attached to my canines. I never would have agreed to have the three crowns pulled and bone grafting done had I bee informed that I could not have 4 implants and 4 crowns. Instead, I would have had bone grafting done for the crown that broke off and 1 implant & crown installed and dealt with the other three crowns when they became an issue (i.e. broke off, which could have been 1, 2 3 + years from that time).

Is it really a non-option for me to have a 6-unit bridge?

Thanks in advance.




      

[Hamidreza Nassery , DMD, FICOI]

I read all your history, I think that you actually got lucky. I am Gp who does his own implants and restores them. After 17 years of dealing with this I have to tell you my first choice in that area , because of the esthetic demands is to put two implants and then build up the rest with connective tissue, and carve out my pontic areas. I think that would give you, your best esthetic result. You can place two very secure implants in the #7 and #10 positions and then make very nice bridge over them. It would work, if the rest of your bite is ok.
The issue with the 6 unit bridge.. it is a bad choice, you can certainly do it but it will fail will take your canines with it, then you are going to have an even bigger problem on your hand, both surgically and esthetically.
Finally, with your smoking, yes you are at a higher risk for failure, but here is what I do with my clients.. I put them on the patch about a week before the surgery, and they keep going for about another week after. most poeple who are putting that kinda investment in their  mouth will be able to handle..
I hope this helps you decide.. Good luck.

[ravenouscrow]

ALLLLL Dentists recommend implants ...why? because it's a money mill for them and a money pit for you that most insurance doesn't cover....
And I don't believe they've progressed alot since my poor deceased aunt had them...
they gave her a hell of alot of pain and aggravation in her old age...the implants that
is

[Gellia]

I went through the same thing as you.  I just had my four front top teeth removed and four implants placed last year.  I couldn't be happier with my decision!  

I'm sorry you can't get all four put in but I agree with the first poster that a two implant supported bridge is your best choice.  A six unit bridge is just too long a span to survive very long.  The stress of a six unit on your canine teeth will eventually take them with it.  I had to decide on the very same thing.  

I wish I could have gotten the two implant bridge!  It would have been cheaper for me and would have been more aesthetically pleasing but I needed the support of all four due to bone loss.

I think your dentist has the right idea and the first poster that recommended the patch is the way to go there.  Not all smokers have an implant problem, but I can almost guarantee that a six-unit bridge will fail very quickly then you'll be stuck with 6 lost teeth instead of four.  

Personally, I think you'll be very happy with a two implant supported bridge.  They look fabulous especially if you have a high smile.  The procedure wasn't bad either.
Having the implants placed (and I'm a dental phobic - big time!) wasn't any worse than a filling.  The shots were the worst part.  After that...nothing.  I was amazed and now with my permanent crowns on, my smile looks great!


Hoping the same for you.
My best to you,

Gellia