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Dental Health  (Expert Forum)
 | 
MS, Implant or Bridge?
Answered by
Private Practice CA
Questions in the Dental Health forum are answered by Dr. Jerome Tsang and Dr. Jerome Bogin. Topics covered include bridges, cavities, crowns, and x-rays.

MS, Implant or Bridge?

by JDag, Jul 17, 2008 03:19PM
I am 52.  I recent had tooth #14 (upper left) pulled due to an abscess and failed root canal treatment.  First tooth I have ever lost.  I have multiple sclerosis (dx 27 years) and am on immunosuppressant drugs (Avonex and Cellcept).  I am also osteopenic due to past use of steroids to treat my MS.

I now have to make the choice between a bridge to replace #14 (compromising the two healthy adjoining teeth used as anchors) or an implant.  My greatest concern is what is the best choice for my teeth and my overall health.  The danger of a failing bridge, need to replace it more often and the extra dental hygiene attention it may demand to avoid decay; versus an implant (stronger-longer lasting) and the potential for infection both of the post and sinus area (14 is close to the sinus), and the fact that I don't have the strongest bone to begin with.  Am I even a good candidate for an implant?

I am leaning towards the less invasive solution (a bridge) because of all the stories I've read about problem's people have had with infection (which I need to avoid).  I'm loosing perspective.  Any experience/opinion with someone in my situation?  Any advice would be greatly appreciated.

by Jerome Tsang, DDS, Jul 17, 2008 09:05PM
To: JDag
Unfortunately I don't do dental implants myself.  You would need to consult with the doctor who would do the dental implants to tell you if there are any contraindications or not.  As far as I know, there are not too many contraindications for dental implants.  Your doctor would need to inform you and help you to decide if an implant has a good chance of success in your particular case.

But assuming that you are a good candidate and that the success of an implant is high, I would personally opt for an implant over a bridge, especially if the other two teeth that are needed for a bridge are "virgin" teeth that don't have extensive dental work done.  It would be much easier to maintain the hygiene on a dental implant versus a bridge and the length of service is generally longer with an implant than a bridge.  In addition, if you do place a bridge, further bone loss would occur if there was no implant in place, reducing the chance (or require more bone grafting) to place an implant in the future.

Also, financially, an implant would probably cost more than a bridge.  If you require dental work on the other two adjacent teeth, it may be more economical to do a bridge as long as you maintain your oral hygiene.  


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