Implant vs bridge (teeth, implants, hurts, dentist)
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I need to replace a center front tooth. It already has the largest titanium rod and had a Captek crown over it which broke. On both sides of the broken crown, I have had root canals and have Captek crowns. My dentist referred me to a periodontist for an eval which I skipped when the secretary said the implant would run $6,500.00. I did not have the eval so I don't know if it is appropriate for me. I just want to learn a lot more about a bridge vs an implant before I proceed.
There should not be an extraction because there is no tooth or root. Maybe the titanium post would have to come out. It seems that I may be a night grinder. It seems like a bridge would be much easier on me.
I am 65.
From reading the posts, it sounds like I would have to go toothless for months if I got the implant. Surely
a crown is placed in the empty spot while the gum heals.
I don't really understand why my dentist doesn't just put another crown on my titanium rod. The crown broke because I fell on the floor. The crown did move and was loose after the fall. It was broken and could not be fixed. The dentist glued the tooth back in and it feels stable. Maybe the rod is now unstable.
I very much appreciate the people who take their valuable time to respond to posts. Thank you.
You should get another opinion. Also, if you have a *rod* then you already have an implant. That's what an implant is. It's like a screw, that is inserted into the bone instead of a tooth, and a crown is secured over it.
If you don't have an implant, then I'm wondering why you have a titanium rod. A root canal doesn't involve inserting a rod, it involves a substance called a gutta percha, which seals the inside of the tooth to protect it from decay, and then a filling material is packed in it, either temporary or permanent, depending on the needs of the patient, and then, again, depending on the needs of the patient, the tooth shaped to fit a crown, and the crown placed over the whole thing. Not all root canals require crowns but front teeth usually do, for aesthetic reasons.
$6500 is a little on the high side for an implant, but bear in mind that a front tooth implant will often be more expensive than a back tooth implant. However, that price would likely include bone grafting. If it doesn't, I'd definitely *definitely* get a second opinion, because that'd be REALLY high priced for an implant without grafting needed. And if that titanium rod -is- the implant (which I suspect) then really all you need is a replacement crown, which shouldn't cost more than $1000, depending on the dentist and depending on whether or not a new cast has to be made to replace the old one. Crowns really don't get that high in price unless it's some high-tech fancy schmancy whatever or some such. But as you have already experienced, even fancy shmancy crowns can break. I wouldn't go cheap, but there's no reason why you have to dish out the big bucks for new technology when a normal porcelain fused over high noble will do the trick for less. As a grinder, you won't want pure porcelain. The fused-on-metal are made beautifully these days, it's like artwork and unless you have a -continual- receding gum problem and curl your lips way up when you smile, no one will ever be able to tell that it's even a crown at all.
Being a grinder makes it much more difficult for a crown to be successful. And therefore I would suppose a bridge may be tricky.
Nonetheless, here is my $0.02...
If this is an upper tooth, I'd skip the implant. At age 65 there is probably some natural bone loss already there. An upper implant will be close to the sinus cavity and those are trickier to place and for long term success. I'd go to a prosthodontist and have them place a bridge. They are specialists and as a 65 year old grinder, this would seem to me to be the best place to land.
If this is a lower tooth, then an implant may be a safer bet (unless you smoke- then under no circumstances at age 65 get an implant as it will probably come with a 40%+ chance of failure). But, again, I'd see a prosthodontist first.
As to the $6,500 for an implant, if it covers the extraction, grafting, implant placement and the crown atop the implant, that's not too bad. If it only covers some of those items, then I'd go to an oral surgeon for a second opinion.
Anon and Blazer, thank you for your kind interest.
I talked with the dentist again today. Yes, I have a post and crown on my upper front tooth # 8.
The crack in the tooth is 4 mil. under the bone.....does that sound right ?.....and he will not place another crown on it. He is concerned that a bridge will adversely affect the other teeth (crowns plus root canals) and recommends the implant. He does not do implants himself. He thought it was OK for me to wait a few months to see how I do and to research my situation.
Yes, the price of $6,500.00 included extraction, grinding, etc. We did not discuss the type of crown to be placed but I want a Captek to match my other Captek so that might be a few hundred more.
I am concerned that if this implant goes wrong, it will do so right in the middle of my smile. And I don't have endless dollars to try to look normal again. I am also concerned about infection until the final imlant crown is placed.
Please tell me if there will be an empty hole in the front of my mouth for months of this implant procedure. Is a temporary crown placed during this time ?
Please tell me if there will be an empty hole in the front of my mouth for months of this implant procedure. Is a temporary crown placed during this time ?
Thanks so much for your imput.
Sue
A "flipper" can be made. They aren't very comfortable to wear but it can easily be done. It's a small prosthetic appliance you can wear with a false tooth in it.
One suggestion about an upper implant at #8.
Make certain you have a CT scan done first. You may need a sinus lift as well as grafting. The CT scan is the most accurate way to measure bone density and amount of bone depth. Both are critical to type and length of implant. To me, at your age and at #8, to do less is below the standard of care. If the sinus cavity is perforated (it happens occasionally) it will not be a pleasant experience and can jeopardize a successful repair. Also, I still recommend an oral surgeon in your particular case. Sometimes a periodontist or general dentist are fine for an implant, but at age 65 and this being in the upper center a specialist is warranted.
Blazer you can bet I will get the CT scan. Right now, I feel like I am trying to make a major decision without much information. The sinus involvement concerns me. I fell on my face on the tile floor and my nose still hurts. It isn't broken but it is swollen and will be awhile until it is back to normal. So should I wait until my nose is healed to get the CT scan ?
Do you have an opinion about the one step implant which would be much easier on me ?
Blazer you can bet I will get the CT scan. Right now, I feel like I am trying to make a major decision without much information. The sinus involvement concerns me. I fell on my face on the tile floor and my nose still hurts. It isn't broken but it is swollen and will be awhile until it is back to normal. So should I wait until my nose is healed to get the CT scan ?
Do you have an opinion about the one step implant which would be much easier on me ?
Sue
As to when to do the CT scan, call your local oral surgeon.
I am not a fan of one step implants. Statistically they fail much more often than traditional ones. That said, if it's a mini implant then I'd think otherwise. And given it's in the #8 area it may very well be such. But do sit with an oral surgeon and ask all these questions (and more)- am I a candidate for an implant? do I need a sinus lift? Will a mini implant work? What type of bone grafting will I need? And so on...
its in a cosmetic region of your mouth.. so that may cost you depending on who restores the tooth.
but it is not in a high traffic area so if you comfortable with a flipper, then as long as you remember NOT to chew on it, you'll be fine.
it will come down to your finances and how comfortable you are.
i would look for a specialist. or at least someone who has experience placing implants as well as someone who has experience restoring teeth. sometimes its the same person. most of the time it will not be. but that will be up to you and how you feel after meeting some Dr's.
i wouldnt worry too much about sinus procedures since #8 isnt anywhere near it. unless there was some sort of freak trauma.
mini implants are becoming more and more popular. they use to be just a temporary solution, but they're gaining ground and if the surgeon feels comfortable with the placement, and whoever restores it is comfortable, it could be a solution. but a traditional implant, IMO, is always the better route.
like the other posts have said, a CT scan will give you a lot of answers, especially if you need grafting. make sure its a real cat scan machine. lots of dentists claim they can get an xray, but it is not the same.
so sit back and relax. you arent alone. tons of people are very very concerned about procedures like this because it can be a big investment and a big surgery.
thats just my $.02 (pretty much what they all said, almost)
Raleigh, thanks for the heads on on the CT machine . How would I know the difference ? The people who use the machine will tell you anything.
Blazer, please tell me slowly. Are you saying I can't get a regular temporary crown placed in the empty space in my mouth during the healing time until the crown is placed on the implant ?
Raleigh, thanks for the heads on on the CT machine . How would I know the difference ? The people who use the machine will tell you anything.
Ask the specialist if they use a CT scan, and if not, why not. An x-ray will not give a real accurate measurement and there is some sort of an error factor they use. The doctors I know who place implants with x-ray only state they take the reading and then back off the implant by 2mm and it seems to work for them. Also, I am not a dentist (I'm a dental risk manager and malpractice claims adjuster with 13,000 claims behind me) so my opinion is not overly learned, but I'd be surprised if a specialist didn't use a CT scan for your implant for the two reasons I have already stated- 1) when placing an implant towards the sinus cavity the length of the implant so as not to leave it too short (the implant will withstand less pressure from chewing) or to long (perforate the sinus cavity) and best determine how much grafting material to use and if a sinus lift will be required, and, 2) bone density is different from place to place in the mouth and that will determine how much pressure the implant can withstand and what type of an implant will be best to use.
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