2 implant bridge vs 4 individual implants teeth 7-8-9-10


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Hey you all, I'm currently faced with a hard decision and am seeking advice. After having my top four teeth removed 4 1/2 months ago I now have the option of having a 4 unit bridge supported by implanting 7 and 10 or individual implants placed for each missing tooth. Financial benefits aside I just want what's going to be best in the long run. My main concerns of the implanted bridge is bone loss in the space of 8 and 9. Another concern is the hollow feeling that having a bridge there may cause. What would you do? Any insight would be helpful as I gather information before making this decision, thanks in advance.

Attached is an Xray from the beginning of January 2020
P1.jpg
 
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MattKW

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For the moment, I'd suggest you simply get a partial denture while you spend time and effort on the other apparent decay in your teeth.
Notably: 4, 13, 14, 18, 20, 29, and 31. There may be more that are not easily visible on this OPG - you'd need bitewings. You may end up extracting more teeth.
Then I'd get the wisdoms removed.
Then come back to implants, maybe.
 
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For the moment, I'd suggest you simply get a partial denture while you spend time and effort on the other apparent decay in your teeth.
Notably: 4, 13, 14, 18, 20, 29, and 31. There may be more that are not easily visible on this OPG - you'd need bitewings. You may end up extracting more teeth.
Then I'd get the wisdoms removed.
Then come back to implants, maybe.
Thanks for the response MattKW. Ideally I was hoping to get it all done, including the cavities, in one pass and if any others did call for extractions than go for immediate implants on those as well. I understand it may take a number of sessions to get to all of them though unless not then I'd be willing to get it done, or at least in the shortest window possible.
 

MattKW

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Have you had bitewings and do you have a treatment plan organised to show us?
 
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I do have some that were taken from the beginning of November 2019 attached here. As for a treatment plan I don't. These were taken only a few months after having 7-10 crowned and just about a week before having them unfortunately extracted. Its been a rough ride so far. The dentist that removed the crowns was different from the one who placed them. Just before the procedure puss came out from the top pallet of my mouth where he had stuck the needle. I don't think it was necessary to extract all four teeth as only one looked in bad enough condition but he left me with no other option. It was a very unfortunate turn of events for me and regret it deeply having had gone to that dentist.
Anthony Leon Pano 10-31-2019.jpgAnthony Leon X-Rays 10-31-20191.jpgAnthony Leon X-Rays 10-31-20192.jpgAnthony Leon X-Rays 10-31-20193.jpgAnthony Leon X-Rays 10-31-20194.jpgAnthony Leon X-Rays 10-31-20195.jpgAnthony Leon X-Rays 10-31-20196.jpgAnthony Leon X-Rays 10-31-20197.jpgAnthony Leon X-Rays 10-31-20198.jpgAnthony Leon X-Rays 10-31-20199.jpg
 
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How old are you? Early 20s?
Yea sorry, forgot to mention my age. Actually late 20s, Im 29 now. I don't do drugs. I do eat a lot of fruit. I was given many rounds of antibiotics growing up and one big dose 5 years ago that nearly took me out. Since then have learned that a history of antibiotic use could lead to teeth decay which is why I mention it. I also neglected going to a dentist since I was about 14 until just recently in the past year when all this happened. I did have decay on 7 and 10 but as for 8 and 9 I believed were crowned at the dentists convenience but I learned to late when all this drove me to research on my own the different dental procedures. I wasn't even aware of what crowns were until midway into the process of getting my four front teeth ground down. I was expecting some composite fillings on 7 and 10 at the most.. but like I said, I learned to late. Now Im just trying to go about the rest wisely. I know there's still a lot ahead of me and I deal with depressing thoughts everyday since all of this.
 

MattKW

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Antibiotic use doesn't cause decay. The pattern I see in your teeth is probably sweet drinks (or lollies) and neglect. If you don't get your hygiene and diet in good shape, then you will waste your money on anything you do. Implants are not necessarily better than real teeth and will fail if your hygiene is poor.
When I have a bit of time, I'll work you up a Treatment Plan (TP) as I see it with sequencing, but ignore the Item Codes (Australian). You really need to get a proper TP from your local dentist with costing. This is going to take you quite some time and expense, and a few unknowns with the more severely damaged teeth.
 
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Antibiotic use doesn't cause decay. The pattern I see in your teeth is probably sweet drinks (or lollies) and neglect. If you don't get your hygiene and diet in good shape, then you will waste your money on anything you do. Implants are not necessarily better than real teeth and will fail if your hygiene is poor.
When I have a bit of time, I'll work you up a Treatment Plan (TP) as I see it with sequencing, but ignore the Item Codes (Australian). You really need to get a proper TP from your local dentist with costing. This is going to take you quite some time and expense, and a few unknowns with the more severely damaged teeth.
I really appreciate you taking the time to elaborate. I feel your passion for dentistry and if you do find the time to, it would definitely be of use. I understand hygiene is important just as much for implant care. Ive always kept up with brushing at least twice a day, once upon rising and before sleep but hadn't kept up with flossing much. I just feel like maybe the health challenges I faced after taking that round of antibiotics (2g azithromycin) for an infection involving my bladder some years ago has to do with the cause because the teeth most affected are related to the urogenital, kidney, and bladder meridians according to the chart. Since then Ive adopted a raw food diet of solely vegetables and fruits that's helped me manage symptoms immensely but maybe not so much my teeth. Anyways thanks for all as I battle these issues. Much love.
 

honestdoc

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Urologists usually recommend acidic fluids like cranberry juice and supplements to maintain and prevent urinary problems. Cranberry alone is too sour to ingest thus sugar is added to make it tolerable. These combinations are very damaging to your teeth as Dr. MattKW mentioned. I would recommend 5000 ppm fluoride supplementation to prevent further teeth deterioration.
 
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Urologists usually recommend acidic fluids like cranberry juice and supplements to maintain and prevent urinary problems. Cranberry alone is too sour to ingest thus sugar is added to make it tolerable. These combinations are very damaging to your teeth as Dr. MattKW mentioned. I would recommend 5000 ppm fluoride supplementation to prevent further teeth deterioration.
Thanks for the response. I will keep this in consideration.
 
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Another question I had about implants in my situation where Im missing 7-8-9-10. What do you guys think would be best. A) to implant 8 and 9 with a bridge to 7 and 10 as I seen done in many videos done or B) implant 7 and 10 and go that route? Just asking for opinions, thanks.
 
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MattKW

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It would largely depend upon bone thickness and the likely aesthetic result. I'd think it more likely to have implants at 8 and 9, then cantilever the (smaller) 7 and 10.
 

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