A Chip Off The Old Block
Q: Dr. Crapo: Many years ago (thirty-five plus), I had extensive bridgework. I lost my right eye teeth and the one beside it towards the front. Over the years it has held up well but I’m hard on my teeth. I’ve broken off porcelain from my eyetooth, which I guess is a fake tooth. The bridge is still hanging in there but I had to have the piece of porcelain bonded back on. I know it’s just a matter of time till something bad happens – so I went to a dentist to ask him about dental implants for those two lost teeth. He said I didn’t have enough bone for that, so I’d have to get a new bridge. He said the bridge might have to be a bit longer or larger, I can’t remember which, because the teeth the bridge is fixed to won’t give me the same life as this one did. He said I was losing some bone support around the anchor teeth, so more teeth had to be included so the bridge would last.
About fifteen years ago I had lower implants on both sides and they’ve been great. I’d sure like to have implants if there’s any way – it seems like they’re so strong. The bottom crowns that were made for my lower implants make eating such a breeze and I never have any sensitivity – way better than my own teeth. I’d sure like it if dental implants were possible.
A: Imaging technology allows us to see and determine the possibilities of a situation like yours. As you may know, implants must have good bone in all three dimensions – length for adequate strength to support a crown – (in natural teeth the root makes up approximately two-thirds to three-quarters of the entire length of the tooth and is anchored in jaw bone) - width of bone to approximate the titanium root (implant) to a similar position of the missing teeth and in proper relationship to your existing natural teeth beside them - finally thickness of bone for bulk and dimension to accept, house and surround the root-like cylinder screw which is what the implant is.
If you have enough length and width but not enough thickness, which can be remedied with a piece of bone that is taken from your jaw and relocated into the spot where the thickness is needed. This type of bone graft takes about four months to heal and fuse to your existing bone that once housed those lost teeth, then at four months dental implants can be placed and three months later, crowns can be made. During the surgeries a temporary bridge is fabricated so that the space is not unsightly. Though this is more involved it is a common practice and produces excellent functional results.