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Cadillacs Break Down Too!

Q: Dr. Crapo: Many years ago I had four implants put in and
very nice bridge work that has worked extremely well. It was, I was told, the Cadillac treatment. It has served me well for twenty plus years. In the past while, part of the bridge came loose, so I went to a dentist to have it
re-cemented, but the dentist could not get the bridge to come away from the
implants. He could not figure out what the problem was, so he called the
original dentist, who told him it had been cemented with temporary cement. Again,
he tried but to no avail. Meanwhile I’m walking around with a loose bridge and
no one can figure out how to tighten it up. I thought it just needed some new
glue and I’d be right as rain – silly me! Do you know what’s going on? How can
I get this fixed? I’m afraid something bad might happen. I’ve been assured that
the implants aren’t loose so it must be the bridge. I’m really perplexed and

another “p” word that I can’t say! Please help me to understand.

A: The problem with your bridge is one that
doesn’t happen very often, but it does happen. The rationale for temporary
cement is that bite forces in the mouth might overload part of the implant
system. In a person with a forceful bite, temporary cement will breakdown before
any part of the implant/crown system will breakdown (at least in theory). Thus,
the bridge supposedly comes loose because of cement breakdown instead of
breakage of the bridge. Usually the bridge is easily removed and re-cemented.

In some cases, the temporary cement breaks down too frequently, which is a
nuisance. In your situation, you may have experienced the worst kind of luck -
i.e. part of the implant system is loose or broken. Most of the time, it is the
screws that secure the housings upon which the bridge is cemented, that have
come loose. The temporary cement won’t give because all of the movement is in
the screw/implant connection. If too much pressure is applied to the bridge to
get it off, you may strip the threads of the securing screws and the inner
threads of the implant. That would render the implants unusable. To salvage this situation, the bridge will have to be carefully cut off and the housings reattached. Yes, it does mean a replacement, but you have many options. If you replace the loose part of the bridge, I’d
also suggest another implant or two before doing so. Doing this will prevent
this from happening again. When your type of bridge was done, the theory was
that four implants were enough. Most of the time it worked. Your bite has not

overpowered the implants, but it has overpowered the bridgework.

If we can help, we’d like to. Call 778-410-2080 for a consultation.


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