Can a Maryland Bridge Be Attached to Two Implant Crowns?
I have two dental implants, both on back molars. Until recently, the tooth before them was healthy. Now that one needs to be extracted. Would it be possible for me to place a Maryland bridge between the two implant crowns?
Dave
Dear Dave,
While technically you can use a Maryland bridge between the two implants, I would not recommend that option. First, to properly place a Maryland bridge your dentist would have to cut grooves into the crown, as shown above. Second, the best bond you can get is when you affix the wings to natural tooth enamel. The bond to the porcelain will not be as strong. I do not think that your bridge will hold long.
So, what do you do? Ideally, your dentist would have anticipated that you could lose the tooth between the two implants you already have. Then he would have aligned the implants in a way where you could unscrew the two adjacent dental crowns and affix a traditional bridge to the two implants. If that is not possible, then I would see if you can get an additional dental implant in the spot. If you’ve only recently lost that tooth, then there should still be enough space to fit another implant.
There are other options if that doesn’t work, such as a removable partial denture or even a dental flipper. Obviously, though, the ideal will be the implant, so start with those options. Either way you do need to replace the tooth with something. If you don’t it will throw off your bite. In addition to jaw pain, headaches and bite problems, you could end up with TMJ Disorder.
This blog is brought to you by Moline Dentist Dr. Thomas Goebel.
Bone Grafting Did Not Work
My dentist has done hundreds of dental implants with great success, but for some reason mine was a bust. He did all these pre-diagnostics, which cost a fortune, then told me I needed some bone grafting done. He’d been training on that, so I went ahead and did that, too, with him. More money. After the required healing period, he went in to do the implant surgery but did not place the dental implant because he said there still wasn’t enough bone. He’s now offering to give me a dental bridge. Here are my questions. First, was he just milking me for surgeries? Second, should I get the dental bridge or go somewhere else to get the implant? Does the bone thing matter?
David
Dear David,
I’m going to start with your last question. Yes, the bone thing does matter. The only way for the dental implant to remain securely in your mouth is for there to be enough bone available to integrate with the implant. This bone is important even for your natural teeth. One of the reasons that people with untreated gum disease end up losing their teeth is because the disease eats the bone that supports their teeth.
As for whether he was just milking you for money, I sincerely doubt it. It sounds more to me like you have a fantastic dentist for two reasons. First, he’s trying to keep up with the developments in his field and learn them in order to serve his patients in the best way possible. You’d mentioned he’d been training on that. All people, no matter what the field, when they are learning a new skill will have failures. That’s what learning is like for everyone. But, he’s learning. That will only end up better for you in the long run.
Second, he has integrity. If he were trying to just take your money, he would have just placed the implant knowing the bone grafting did not work. Eventually, your implant would have failed, but it would likely take a year or more and have been impossible to prove that he was at fault.
As to whether you should get the dental bridge, that is a fine alternative to a dental implant. This is especially true if one of the adjacent teeth already needs a dental crown. Then, you’d be knocking off two procedures at once. You can certainly still get the dental implant if that is the replacement you really want. However, you’ll need to go to a different surgeon to have at least the bone grafting part done.
I know you’re frustrated, and I understand, but it does sound like your dentist was trying his best with a procedure that was new to him and was up front with you when things went awry.
This blog s brought to you by Moline Dentist Dr. Thomas Goebel.
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Alternatives to Dental Implants?
I had an accident that caused me to lose a tooth. I was hoping to get a dental implant for it, but my dentist said I wasn’t a candidate because it is a front tooth. I was disappointed but need to find a replacement for this tooth. What are my next best options?
Corinne
Dear Corinne,
I am sorry to hear about your accident. Given what you’ve said, My first suggestion is that you find another dentist. You can absolutely get a dental implant on a front tooth. My guess is your dentist does not do dental implants because he doesn’t have the training. It is a procedure that he would have needed to get post-doctoral training in. Rather than send you to a dentist that could do the procedure, he lied and said you were not a candidate. Not the best dentist for you.
I would like you to get a second opinion from someone else. In most cases, if you are in good general health, then you should be a fine candidate for dental implants. There are exceptions, of course, which is why I want you getting a second opinion.
If for some reason it turns out you are not a candidate for a dental implant, you do have other options. Your next best option is to get a dental bridge. Though, that does require the two adjacent teeth to have dental crowns placed on them. Your false tooth will be suspended between the two crowns. Like the dental implant, it is permanently placed.
I would not give up on the idea of the dental implant yet. Get that second opinion.
Whichever procedure you end up with, you may want to consider teeth whitening first, depending on how satisfied you are with the current color. Once your dental implant crown is made, the color is permanent and will not respond to whitening. If you have the bleaching done first, you can match your new crown to the color you’ll be proud to keep around.
This blog is brought to you by Moline Dentist Dr. Goebel.
My New Crowns Are Not White Enough
My dentist sent the crowns back to the lab to get them whiter. I still think the shade is off, but now the crowns are turning yellow. I asked my dentist for a refund, but he wants to try again with the crowns. I hate going through this again. And now, my teeth are not as white as they were at first. If the crowns were not turning yellow, I would accept this mess. But new yellow crowns are not acceptable. What are my options? Thank you. Lydia from Cedar Rapids, IA
Lydia,
Thank you for your question.
If your crowns are truly ceramic and in good condition, they will not turn yellow. It is possible that something damaged the glaze on your crowns and caused discoloration.
What Can Cause Dental Crowns to Discolor?
Dental crowns may discolor if exposed to equipment or chemicals that damage the glaze. Some factors included:
- Power polishing equipment – The Prophy Jet and other instruments work well on natural teeth but may damage the glaze on ceramic tooth restorations.
- Acidulated fluoride – The acid can etch the glaze and leave your replacement teeth with a satin finish that attracts stains.
We recommend asking an expert cosmetic dentist to examine your crowns and determine why they are yellowing.
Challenges Matching Crowns to Super-White Teeth
It is challenging to match crowns to super-white teeth without advanced cosmetic dentistry training. You chose BL1 as the shade for your crowns, which is whiter than any shade of natural teeth. And in most cases, your teeth are so bright that they do not look natural. But you whitened your teeth before getting crowns, as you should, to ensure the crowns match your natural teeth.
Although teeth whitening can get your teeth brilliantly white, not everyone’s teeth will lighten to shade BL1. Without advanced cosmetic dentistry training, it is challenging for a dentist to match your crowns with your teeth. Unfortunately, your dentist requested your crowns before completing your at-home whitening allowing your tooth color to settle.
Although you may not achieve BL1 shade for your crowns and teeth, a cosmetic dentist will help you
get natural-looking results. Before requesting treatment from a cosmetic dentist, request a consultation. Ask to see before and after pictures of dental crowns on front teeth.
Dr. Thomas Goebel, a Moline, Illinois dentist, sponsors this post.