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One Good Sneeze...!


Dr. Crapo

Question:

Dr. Crapo: As I enter my eighth decade, I realize I’m doing better and am more fit than my teeth. Over my childhood and early adolescence, I did not have good dental care and as a result teeth that were filled with decay were taken out. In my adulthood, I started to get dental treatment. That helped but I had lost most of my molars so I didn’t have back teeth. It wasn’t too bad, so I just got by. Over time I got crowns put in and then the option of partial dentures was presented. I liked the idea but the reality was not as good as the idea. It took some adjusting before they fit right. The first set was the most comfortable, at least for a couple years. Then the teeth that they were attached to started to rock and hurt. I lost more teeth because the rocking teeth lost their bone. A second set was made after the teeth that were loose came out. That event repeated itself and then I got some bridgework to strengthen the teeth and a final set was made that never did feel right. Presently, I have a bridge on the upper front that’s so loose I think I’m going to sneeze it out. I’ve resisted a denture for a long time. I would like to know if implants will work and if they will hold in teeth so I don’t have to wear a denture.


Answer:

To answer you directly, it may be possible if the bone surrounding the loose teeth has not been destroyed extensively. Immediate implant placement and connection to a bridge on the same day mandates good native bone for strong implant tightness (think of a screw going into a board versus styrofoam). If the bone is spongy, a bone graft would be placed and healing allowed for four to six months before the implants could be placed. That time frame would be determined at the time of the surgery. If grafting is required, you would be fitted with a denture; then when the graft has encouraged excellent bone creation in the weakened sites, the implants would be placed and the bridge created. Good three-dimensional x-rays (Cat Scan) allow for helpful evaluation before hand but in the presence of disease the final judgement of implant placement comes at the time of surgery when all the variables i.e.: bone volume versus bone hardness, can be evaluated. Most of the time implants can be placed but you should be prepared to wear a denture for a short time, if at surgery, the clinical judgement of the doctor is to graft and wait.


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Based on actual patient cases.

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