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Old 03-15-2012, 09:14 AM
 
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Went to an Oral Surgeon today. need tooth 13 extracted , it has had two root canals, two crown and a crown lengthing already. Crown keeps coming off. dr recommended that I also get a bone grafting done with the extraction at the cost of 798.00. I u derstand the need for the graft if I was getting an implant BUT I asked if I didn't want an implant later if I needed the bone grafting done. They told me yes because the bone will collapse where the extraction was done ?? Anyone have any opinion one wheter I actually need the graft if I'm not getting an implant ? Thanks
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Old 03-15-2012, 10:20 AM
 
Location: In a house
13,250 posts, read 42,622,995 times
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Quote:
Originally Posted by newred5 View Post
Went to an Oral Surgeon today. need tooth 13 extracted , it has had two root canals, two crown and a crown lengthing already. Crown keeps coming off. dr recommended that I also get a bone grafting done with the extraction at the cost of 798.00. I u derstand the need for the graft if I was getting an implant BUT I asked if I didn't want an implant later if I needed the bone grafting done. They told me yes because the bone will collapse where the extraction was done ?? Anyone have any opinion one wheter I actually need the graft if I'm not getting an implant ? Thanks
The information you're providing is unclear. Tooth #13 is a canine, which means it only has one root. How can you have two root canals on it? Why did you need a second crown? If the crown keeps coming off, then there's something wrong with the cement. OR, you are doing something you shouldn't be doing (such as trying to crack nuts with your canines, or getting hit with a hockey puck during practice).

A canine is one of the teeth readily visible when you smile. For whatever reason, the root canal has failed, and the dentist has recommended extraction. You can get a bridge, or you can get an implant, but it's in your best interest to fill that gap one way or another. An implant is going to be the best option, if you can afford it, because of the nature of the procedures:

1. You already know the tooth has to come out, so it's a given.
2. If you get a bridge, then they'll have to shave down the tooth on each side of that empty space - if there's nothing wrong with either of those teeth, then this procedure will effectively make those teeth *require* artificial covering, where before, they didn't need it, because there was nothing wrong with them. They have to grind those teeth down to make room for crowns, that are the "anchors" to the bridge that fills in the gap where the tooth was extracted.
3. If you get an implant, the other teeth are not affected. Bone grafting isn't always necessary but it's fairly common.
4. The expense for grinding 2 teeth down and building a bridge for all three teeth, is around the same as a single implant. A bridge is a minimum of 3 teeth's worth of "procedure:" the extracted tooth, and one tooth on each side of the new gap.
5. If the worst case scenario occurs, and you have a cavity in one of the teeth that is bridged, they'll have to remove the entire bridge, just to clean out that one cavity on that one tooth. And then build a new bridge to accommodate the filling. Very expensive. With an implant, if something goes wrong with one of the teeth on either side, it's business as usual, no need to remove anything, just drill and fill and you're good to go.
6. If #5 occurs, dental insurance does -not- cover the cost of bridge removal and replacement. It -does- cover a normal filling.
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Old 03-15-2012, 10:41 AM
 
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Thanks for the response, sorry I was u clear.
I had a root canal and crown done about 11 years ago. About five years ago there was an infection at the bottom of the root so the root canal was "redone" and a crown lenghting and new crown done as well because there wasn't enough tooth above the bone to hold the crown ?
Now the crown is loose and the dentist and oral surgeon say there is not enough tooth left to keep the crown on no matter who many times it's reglued
. Bridge isn't an option because one of the teeth next to tooth 13 has had a root canal as well and dentist doesnt feel the tooth with a root canal is strong enough to anchor a bridge.
Insurnace would cover all the bridge but nothing for the implant (except the cost of the crown portion).
I know the tooth has to come out. If the tooth comes out and I don't do the grafting am I asking for future problems as the Oral Surgoen says that the bone will cave in ?? Doesn't recommend getting an extraction without then graft ??
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Old 03-15-2012, 10:53 AM
 
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AnonChick probably knows better but...

Two things will happen. The bone will shrink slightly since it's no longer supporting a tooth... but not "collapse". The real problem will come from the other teeth moving forward into the gap. This will ruin the structure of all your other teeth.

The only reasonable solution is to get the implant.
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Old 03-15-2012, 05:21 PM
 
Location: In a house
13,250 posts, read 42,622,995 times
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Basically NJBest has the right idea.

Most people have a little bone loss here and there, but when you know you have it, and you know there's something you can do about it -now-, you're better off doing it now. Because it will only get worse, if you don't fix it now. You have to choose:

Do I want to spend a few thousand dollars, and a couple of weeks of discomfort now, to fix this problem?

OR

Do I want to spend many thousands of dollars in 10 years, and several months of discomfort, to fix the problem, plus all the damage done during the last 10 years because I did nothing to stop it from getting worse?

Grafting is typically done around 4-6 months before an implant is put in, because it takes that long to make sure that the sliver of bone added to your mouth "takes" and becomes absorbed into your own bone tissue. You can do it now, or you can do it in a few months, but remember that you'll be without a tooth in that spot for at least 4 months. So if you wait and get it done next year, it'll be a year -plus- 4-6 months before you get the implant.

If it were me (and I've been there) I'd just get it done. I've just made an appointment to have my bridge destroyed and removed, because there's a cavity in -one- tooth that the bridge is attached to. I already paid $3000 for the root canal, the extraction, and the bridge to be placed ON those three spots. And I'll now have to pay another $3600 to have the bridge removed, and a new one put on, all because of a lousy cavity.

If I knew then, what I know now, I would've sucked it up and taken the implants.
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Old 03-15-2012, 07:33 PM
 
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Anon Chick and NJbest thanks for the replies and advice. I hear what you R saying...I'm just thinking if I just have the tooth extracted and don't plan on the inplant ( cost) why get the bone graft. Yes I know I'll have some bone loss and the teeth behind #13 will move slightly forward but is that really bad ? Can't I get along fine without the implant or am I just fooling myself ?
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Old 03-15-2012, 07:46 PM
 
Location: In a house
13,250 posts, read 42,622,995 times
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There is a possibility that the worst thing you will face in life, is walking around with a missing tooth that is -very- obvious whenever you smile, because it is in a prominent part of your mouth. This can have a profound effect on your self-esteem, your ability to find a suitable mate in life, and even on your chances of being employed in the future, because looks *do* matter, regardless what should or shouldn't be true.

That is the -least- significant problem you will face, as "newred, the toothless wonder."

The worst thing that can happen, is you end up with dry socket and die.

The most likely thing that will happen, is you will have a blaring, gaping, open gap in your mouth that people will snicker about behind your back (or openly, depending on who you hang out with), and eventually have enough bone loss that it affects your sinuses, because your sinuses are *RIGHT THERE* next to that bone that's slowly decaying away. Once your sinuses are exposed, it becomes too dangerous for bone grafting. And then you're just stuck with lousy exposed sinuses, which can end up with continual sinus infections, which sucks big-time.

That is the most likely thing to happen, with a missing tooth in that particular location in your mouth, since you already know you have a history of decay, and a history of bone loss.

The thing with the teeth moving forward is like...not even on the radar of "things you need to be concerned about." Yes, it's likely to happen. But if you're fine walking around with a gaping hole in your mouth a la JimBob's Trailer Hitch And Brew, then it's really not going to make an impact if your teeth are crooked.
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Old 03-15-2012, 08:08 PM
 
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Thanks, I think ?? Already have a soulmate in life, Been married 32 years now....don't care much about what people say behind my back or to my face... Like me they way I am .....meaningful employment, don't need any , retired at 51 years after 29 years in a real tough line of work ... Already have a gap in my front teeth( think Micheal Strahan ) been there since an accident as a kid, had braces moved them a bit closer but still a gap...
Am concerned about sinus issues, actual bones loss ... Not sure I want to shell out 725.00 for a graft then 2350 for implant and 1200 for crown..... Have it but not sure I want to part with that much cash....like I explained earlier , don't really have a Hollywood smile now .....AnonChick I have read many posts by you and seem knowledgable... In will consider what you have said... Thank you
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Old 03-15-2012, 08:21 PM
 
1,380 posts, read 2,288,731 times
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Anonchick
Question, you say you have a bridge ? when the extracted the tooth for the bridge did you get a bone graft ?? My wife has a bridge and didn't receive a bone/socket graft and there was no mention of boneless .. Why is it different if you have an extraction without getting a graft they talk about boneless but when you get a extraction then a bridge , no mention of the boneloss ??Just wondering
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Old 03-15-2012, 09:02 PM
 
Location: In a house
13,250 posts, read 42,622,995 times
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No, I didn't get a bone graft, there was no need for it. First of all, I was getting a bridge, so the gap was going to be filled with -something- in its place, that was anchored firmly on either side. That's what a bridge is, that is its function. To brige a gap, literally. There would be no pressure on the bone caused by either of the other two teeth, because they are now all connected to each other by metal with baked porcelain.

Second, bone grafting is typically done in preparation for an implant. I thought that was -why- you were getting the bone grafting in the first place.

If you have -that- much bone loss that the doctor thinks you need a graft, without an implant, then you have some serious bone loss and shouldn't even think twice about getting the graft. (In other words, set up the appointment and get it done asap, if it's THAT bad). If it's in preparation for a future implant, you might as well get it done now, since it'll be at least 4 months before you can get the implant anyway.

Lastly, not everyone who has implants, needs grafting done. If I decided to get an implant instead of replacing the bridge I have now, when they remove it to fix the cavity on the other tooth, they would not need to do any grafting. That particular part of my mouth has plenty of bone, and the implant wouldn't be drilled too close to the sinus to be a risk.

You should check wikipedia on dental grafting, dental bridges, and dental implants. Although a lot of wikipedia articles have dubious information, these particular topics have been pretty well-written and most of the sources are credible.

If you'd prefer to avoid wikipedia (it's considered a joke in some circles), you can check the ADA (American Dental Association); they have some really great articles on the subject.

Tuft's Dental school also has some great peer-reviewed studies on the subjects as well.
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