Novel approach to implant


Joined
Jun 6, 2020
Messages
2
How long on average would a crown for tooth #20 stay in place if only cemented to teeth #19 and #21? It could also cement to the little remaining of #20, now just below gum line. If it lasts just 3 months, still better than an implant.

My question is how long could this hold?

why this should work
#20 is a low stress tooth ... BEST tooth position for lateral support from surrounding teeth.
The old crown once it had fallen out, it stayed in place even without cement.
This was fine, until the post broke.

True, the post provide stability I won't have with my cement idea,
but the post was only pushing into the mush of the decay that had caused it to fall out in the first place!
If that is all it takes to keep from tipping over, then copious dental cement could as well?
Perhaps a very small post could be put in remains of #20. Or fill 20 with epoxy to place post.

I haven't gotten a dentist to take a breath and REALLY considers this.
There is no risk to trying it. If I find one who will do it, and I'll fly to them.
If it works, will be interesting dental news.

The new crown could have a rounded bottom molded to exact shape of remains of #20.
This alone provides a large contact surface for cement.
New crown is stabilized by adjacent #19 and 21 and cemented to them.
Repair if it falls out is easy - just re-cement.
Four repairs each year is $400 - better than invasive $4000 implant that also doesn't last forever.
(A small strip might be glued across the back of all three teeth if really necessary, like a maryland bridge but not as complex or damaging supporting teeth as with maryland bridge)

I've delayed a month since the post broke and crown no longer stays.
The gum is starting to grow over the remaining tooth.
"Nuking" my jaw with an implant I deeply feel isn't the answer.
The laws of physics tell me cementing should work.
But I don't know teeth, and I need knowledgeable comments.
Please be careful to not sound like dogma ... like a cancer doctor saying chemo is only option.

THANK YOU SO MUCH JUST FOR LISTENING! I realize I prefer a maryland bridge over an implant just by writing this. But I still think my cement idea will work and is best at least to try. The old crown might even be reusable for it.

KNOWLEDGEABLE COMMENTS ARE NEEDED!

x-ray attached (didn't aim very well but show status at gum line etc)





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Dr M

Verified Dentist
Joined
May 31, 2019
Messages
450
Solutions
106
Good day,

Firstly I can't say if the relevant tooth is " low stress " due to not enough information, regarding the rest of your mouth? Are there any opposing teeth, and what is the occlusion like? if this is the dominant chewing side, the tooth can actually undergo additional forces that might increase the stress load.
If a resin cement is used to just stick the crown to the remaining tooth structure and adjacent teeth, it does not guarantee a proper seal of the root canal treated tooth even if shaped properly, due to the crown undergoing forces in all dimensions during passive and active occlusion. This might lead to leakage that could result in infection of the remaining root canal treated structure leading to abscess formation.
There is also no guarantee that once the crown comes loose, the remaining cement might not break off further tooth structure or cause a crack, leading to eventual leakage and infection.
If the remaining tooth structure is above bone level and there is sufficient ferrule, then a new crown and post might be an option, but from the radio-graph it seems unlikely. Otherwise a Maryland bridge might be an option.
I gather from your post that you are not pro-implant and I am not sure on what your opinion is based. Implantology has progressed a lot in the last few years.
" Nuking" your jaw with an implant is not really the right terminology to use here, not trying to sound offensive.
A well planned out and placed implant can last you the rest of your life.
There are always various factors, patient and operator factors, surgical factors and others that could influence the success, true, but this is true for most interventions.
 

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