Q: Dear Dr. Crapo: Twenty years ago I sought out a dentist
because I had neglected my teeth and had a number of severe problems. He was able to salvage five of my upper front teeth and two upper molars (one on each side). He did a good job crowning my teeth and made me a partial denture which has fit very well all these years. Last month I saw him for my regular check-up and he found that my upper right molar, that was anchoring my partial denture on that side, had broken apart under the crown. He said the roots had actually split and the tooth would have to come out. I was very surprised because I hadn't felt any pain. He said when the tooth is removed; he could add a tooth to the partial so I'd have that tooth for chewing.
The problem is I wouldn't have an anchor on that side to support my partial. He said it'll probably be fine but I would have to have my partial relined from time to time, as the bone settled. I have been able to eat anything with my partial and I fear it won't be as strong and will put more pressure on the remaining teeth. Is there anything that can be done?
A: Adding a tooth to a partial denture can work well enough but not when the natural tooth to be extracted is an anchor for the partial and when the person has an extremely hard bite.
Recently I saw a gentleman with a well done partial, custom fit to his crown work. On one side he had a molar as an anchor but no anchor on the other side. His concern was a front crown that had come loose because he didn't have a molar anchor tooth on that side.
Today we have great answers for these dilemmas. Implants can often be placed strategically to act as an anchor. In some cases that anchor can be two mini implants placed in such a way as to use your own partial. In your case, your partial could be attached to an implant or two, through a relatively simple laboratory process. That'll save you money and time.
Last month I ran into a gentleman who required treatment similar to the treatment you will need. Two mini implants were placed. When they're ready to receive a load, they will be fitted to the partial and the anchor tooth removed. The socket site of the failing anchor tooth will receive a bone graft and later an additional implant placed. When finished, his partial will be better than ever.
Based on actual patient cases
Calvin Ross Crapo
Victoria Implant Centre