I need some advice. I’ve been to two dental clinics both of which are giving me completely different treatment plan suggestions. First, I should tell you what is wrong. I had my front incisors replaced with a bridge. My canine teeth were the anchor teeth. They became super loose which how this all started. So, I went to Aspen Dental and they said the teeth need to be removed. So now I have to replace two more teeth. They suggested replacing the canine teeth with mini implants connected to a bridge. My sister told me they have some bad reviews so I decided to get a second opinion. This dentist wants me to replace the canine teeth with full-sized implants then attach a bridge to it, but only with an additional implant in the middle of the bridge. I’m tempted to just go with the cheaper plan, but when I told this dentist what Aspen said, he told me the plan they suggested won’t work. Who is right?
Marla
Dear Marla,
One thing you should know about Aspen is it is a corporate dental chain. These tend to attract new dental graduates with the design of getting some real-world experience in before starting their own practice. There is high turnover and you will likely be dealing with different people quite often.
A Tale of Two Dental Implants
As for the two treatment plans. I agree with the local dentist. What Aspen Dental is suggesting for you, won’t work for long. There are some important dental bridge engineering principles being ignored by them which will cause this bridge to fail. A dental bridge is a false tooth (or in your case teeth) which are suspended between two dental crowns on anchor teeth. You know that because of what you had to begin with. Their lack of adherence to sound principles is likely why you lost your canine teeth. In your new case, they’re suggesting suspending them between abutment teeth with mini implants.
I’m going to ignore the fact that mini implants aren’t designed to support a tooth. They’re mostly to help anchor a denture and you’d need several of them. Even then, they still wouldn’t last as long.
Instead, I want to focus on the engineering.
For illustrative purposes, let’s suppose you needed to replace your first premolar, as seen on the left. It is the tooth in the center of the three teeth which have the blue line. The two adjacent teeth would be considered the abutment teeth which you’d anchor your bridge onto. Notice that these three teeth lie in essentially a straight line. This is good because there won’t be any twisting stress on the teeth.
Now, let’s look at what Aspen is suggesting for you.
Here they are suggesting replacing all your incisors with a bridge and place dental implants on the lost canines as the abutment teeth. This will put a tremendous amount of twisting stress on your new canine teeth causing them to eventually fail.
To prevent that, the second opinion dentist is suggesting you put an additional dental implant in the middle of the bridge. This will work and eliminate all twisting.
I know it is more expensive, but only in the short term. If you go with the “cheaper” treatment, you’re going to end up with serious problems and having to re-do the procedure when it eventually fails (and it will) then have the added expense of bone grafting so you can even have implants again.
Sometimes it is better to go with the treatment that costs more in order to save money.
I hope this helps with your decision.
This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
