I have had for years a three tooth bridge, 18,19,20. Recently this has become a problem requiring recementing into place. The recementing has failed twice because abutment tooth 20 was reduced to a very small size during the original bridge work. My dentist now plans to do a root canal on tooth 20, then insert an implant post and place a newly constructed bridge. I am concerned with all the research I have done on root canals and possible complications.
My question is: why would a root canal be required prior to placement of an implanted post. It seems to me an extraction and implantation of a post would be a more logical and healthier solution for securing a replacement bridge. Also would it be possible for my existing bridge be modified to fit the new implanted abutment? Thanks for any advise you can provide as this is a big cause for concern.

For many years I have had a bridge: 18,19,20. Until recently I have had no problems and then it "popped off". I have had this recemented twice only to lose it again. The core of the problems is the abutment #20 was severely reduced to a very small (less than 1/8" above the gumline) size when the original work was done.
My dentist's treatment plan is to perform a root canal, implant a post and install a new bridge. Needless to say I have seen much negative information about root canal work and am reluctant to proceed with that procedure.
My question is why would a root canal be necessary at all since the implant is placed into the mandible directly? It seems that an extraction and then implant would be a preferable treatment plan. Am I completely off base in questioning the efficacy of the proposed treatment plan? I am also wondering of my existing bridge could be modified to be mounted on the new implant abutment #20? Any advise will be very much appreciated.

Hello, I merged your 2 threads into one so all info is in one place for you.

Hi thescion,

I am in the dental field and can offer you some information here.
I think you may have misunderstood your dentist or he didn't explain things very well.

Just to clarify what you had written .....
You have a 3 unit bridge. Tooth 18 is an abutment crown, #19 is a pontic (fake) crown replacing a missing tooth, and #20 is an abutment crown.

It sounds to me like your dentist wants to root canal #20, then put a post inside of that tooth, build the tooth up with a core buildup material and then use it as an abutment crown for a new bridge. This is not the same thing as doing a dental implant.

The post he is referring to is put inside the center of the tooth. It is used to "supposedly" give the tooth more support because it has been worn or cut down severely leaving it too small to restore properly. The tooth would first be root canaled to remove the vitality or the post would be painful. A note about these type of posts.... they can cause the tooth to fracture as it places too much pressure on the walls of the tooth. So that is something for you to be made aware of before going ahead with this treatment.

Here are some additional concerns with this type of dental treatment....

All root canaled teeth are chronically inflamed and infected. So root canaling this tooth will render the tooth unhealthy and eventually it would need to be extracted. So that means you would have had the root canal, the post, and a new bridge only to end up losing this tooth to infection. Which would mean that the bridge would have to be redone and made longer to replace tooth #20. What also compromises the longevity of #20 even if you did not do the root canal, post, etc..... is the fact that it was severely cut down in the first place. The tooth is unfortunately too small to be an anchor tooth for a bridge, so it doesn't matter how many times you treat this tooth and remake this bridge, it will ultimately fail.

Another option you could possibly consider is to extract #20 and have the dentist make a 4 unit bridge from #18 through 21. Tooth #18 would be an abutment crown, #19 and 20 would be pontics, and #21 another abutment crown.

As for replacing tooth #19 with a dental implant..... if #19 has been missing for more than 2+ years there is a good possibility that there may not be enough bone to hold a dental implant because bone continues to deteriorate after a tooth has been extracted unless a dental implant was put in within the first year of the extraction.

Bryanna

HI BRYANNA,
Thanks for your quick reply to my worrisome problem! I understand the possibility of a 4 tooth bridge but was wondering if extraction of tooth 20 followed by an implant in its place as the new abutment for the three tooth bridge is a plausible solution to this problem. It seems this would eliminate the need for tooth 21 being shaped to serve as the new abutment. If this is feasible do you beleive my current crown could be modified to fit the implant abutment? Lastly what is your opinion of the "flexible dentures" as a possible solution following extraction of tooth 20?