Complications of implant surgery involving sinus lift & bone graft

Discussion in 'Dental Archive' started by Michael Kraft, Jul 26, 2004.

  1. I have received conflicting opinions about what to do about a missing
    upper right molar (tooth #3) that had to be extracted early this year.

    The options appear to be:

    - implant
    - 3-unit bridge
    - do nothing

    Since in my case an implant would involve a sinus lift and bone
    grafting, one dentist advised that I instead get a 3-unit bridge. Two
    other dentists have disagreed because the 2 adjacent teeth, which are
    fine, would have to be reduced to accommodate the bridge.

    Since neither of those options seems that attractive, and since I've
    had no problems since the tooth was extracted, I've considered doing
    nothing -- with varying opinions about whether that's advisable.

    What is the general consensus, if there is one, in a situation such as

    Replies appreciated.
    Michael Kraft, Jul 26, 2004
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  2. Michael Kraft wrote:

    If there is a concensus, it is that the patient should be treated as an
    individual. That means that the decision to restore is based on need
    and reasonably expected consequences of failure to restore.
    The opposing and adjacent teeth may drift, which may predispose them to
    decay, shifting of bite and periodontal disease. Or they may not shift
    at all.
    If you don't miss the tooth and would rather not restore, I'd suggest
    having your dentist take a study model of your teeth, then compare with
    your mouth at 6 month intervals, esp. for the first couple of years to
    see if your teeth are drifting or not. If not, and the adjacent and
    opposing teeth continue to be healthy, you may decide not to restore.
    As for the decision between a fixed bridge or implant-supported crown,
    this depends on several factors:
    1) How heavily restored the teeth adjacent to the space are, whether any
    caries exists
    2) the periodontal status of these and the other teeth
    3) an assessment of your oral hygiene
    4) any history of sinus disease.

    I'm sure I and others can think of other considerations, but you get
    the idea. All the pros and cons of the procedures should be discussed
    with you--there is no one right answer. As I said, if the teeth aren't
    drifting and you chew well there is no rush making the decision.

    Mark & Steven Bornfeld DDS, Jul 26, 2004
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  3. On 26 Jul 2004 11:20:49 -0700, (Michael Kraft)
    What is the condititon of the adjacent teeth and your age ?

    Often okay, but not as desirable as replacving it.

    Joel M. Eichen, D.D.S., Jul 26, 2004
  4. Michael Kraft

    W_B Guest

    What he said.


    Take out the G'RBAGE
    W_B, Jul 26, 2004
  5. Thanks for those replies.
    Michael Kraft, Jul 27, 2004
  6. Michael Kraft

    StovePipe Guest

    ....... Assuming that the adjacent teeth are quasi intact, IOW one would
    hesitate in cutting them down, can one not consider a MaryLand Bridge?
    The advantage would be relatively undisturbed abuttments. It would have
    to be with RPD type wings and rests, of course, to counter the forces
    put on the molar.
    Just a thought.
    Thanks and Boom
    StovePipe, Aug 1, 2004
  7. Michael Kraft

    W_B Guest

    Mancuso has an excellent design for the posterior 'maryland bridge'

    Have a good candidate on deck.


    Take out the G'RBAGE
    W_B, Aug 2, 2004
  8. Michael Kraft

    StovePipe Guest

    blah blah blah

    can one not consider a MaryLand Bridge?
    good.... I'll remember that and post a case for evaluation by youse when
    it comes up. I HATE condemning teeth to crowns or bridges if it can at
    all be avoided. You know why: it is usually 'the final insult and
    injury' to the pulp ----------> ENDO
    StovePipe, Aug 2, 2004
  9. Michael Kraft

    W_B Guest



    Take out the G'RBAGE
    W_B, Aug 2, 2004
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