I have a few questions about implants, but first here is a little bio on my circumstance. I have a couple of permanent teeth that never came in. Ultimately, I had to have the baby teeth extracted, since they were beginning to decay. The second one came out this January. Now I need to fill the gap that the baby teeth left behind and think I would prefer implants over etching the adjacent teeth to have bridges inserted.

It is my understanding that with state-of-the-art biomedical engineering implants of any kind (teeth, hip replacements, etc.) last at most 15-20 years. As a 37 year-old male that hopes to live past 57, is this a sound option? Once an implant fails, what concerns should I have about a new implant in the same location?

Hi TalkingNeuron,

Your statement.......<<<Now I need to fill the gap that the baby teeth left behind and think I would prefer implants over etching the adjacent teeth to have bridges inserted.>>>

I assume when you say "etching" you are referring to what is called Maryland bridges? These are a type of permanent bridge that replaces 1-2 missing teeth by cementing metal "wings" onto anchor teeth with the fake teeth in the middle. They do not require the cutting down of the anchor teeth as in conventional bridgework. The problem with Maryland bridges is decay occuring around the wings. So it is imperative to have them carefully monitored at routine cleanings with periodic xrays. They can also become lose and fall out. They need to be done exactly right for them to have a long lifespan of about 10-15 years.

Conventional bridgework requires the anchor teeth to be cut down and covered by crowns which are called abutments. The fake teeth are called pontics, they are in the middle and soddered to the abutments. The problems with this type of replacement is decay occuring underneath the crowns on the anchor teeth, the bridge would need to be removed and remade. The lifespan of a well fitting conventional bridge on healthy teeth is about 15 years. After that, the cement gives out and bacteria gets in underneath the crowns.

Another replacement option are called "nesbitts". These are fake teeth with acrylic wings that wrap around the adjacent teeth. They snap into the empty space where the teeth use to be. They are removable and should not be worn to sleep. The problems with these are they can pop out while chewing and accidently swallowed.

Dental implants are made of titanium or zirconium. In the US the most commonly used material is the titanium. If the bone is healthy, if the patient is healthy and does not have periodontal disease or smoke .......... and that status does not change in any drastic way ..... if the implants are put in properly and the implant crowns fit well....... the implant itself may never need to be replaced. The implant crown may need to be replaced 10-15 years down the road, but the implant should still be solid. All of those factors play a significant role in the lifespan of the dental implant.

If an implant fails.............
It depends on why it failed as to what can be done to replace it. If it is due to infection or periodontal disease, then the implant should be removed and NOT replaced with another one because it will fail again. If an implant "wears out" (which I have yet to see one in the last 30 years) and it needs to be replaced, providing the bone is healthy, a larger implant (wider, maybe longer) would be placed in the same location as the first one. I have seen patients who have solid, healthy dental implants that were put in their mouths 20+ years ago. In these cases, the bone was healthy to begin with and the patients have had no significant health issues as well.

You do have some choices...... and if you and your bone are healthy, the implants may be the wisest choice for you to replace your missing adult teeth.

I hope this information is helpful to you........ all the best!

Bryanna

My conventional bridgework has lasted 48 years and is still going strong. I must be one of the lucky ones. Even if decay could now be going on, I have not had to replace the bridge every 10-15 years and that would have cost some bucks each time as well. Again, I must be one of the lucky ones. I have heard of others as well who have had there bridgework for years.

Hi Kitt,

I assume that you have had this bridgework recemented a few times over the last 48 years? The reason being is that the cement only has a shelf life of 10-15 years depending on which cement was used and how it was used in the first place.

Also, the materials used to fabricate the bridge wear out over time from the constant chewing forces on them. The porcelain becomes thinner which slowly alters the bite and can cause other teeth to become worn down as a result.

So although it is expensive, it is healthier for the sake of all of your teeth to have the bridge remade after about 15 years.

Just wanted to pass that info onto you and others who may not have been informed about this from their dentist... :-)

Bryanna

I have never had it recemented. I also was told that nowadays the cement is not as good as the old kind used when I had it done. In fact, my dentist now uses the old kind of cement. At least my dentist likes it better. Apparently it was much better than whats out there now.

I also have been very careful with my bridge for all these years and have taken great care with it. Again, I have never had it recemented in these 48 years and it's still going strong. My bridge does not hit any other teeth when chewing. And I've been very careful how I bite. For example, I cut the corn off of the cob and I slice applies, etc.

Hi Kitt,

The "old" cement that was used 50 years ago still only has a 10-15 year lifespan if that. Once the adhesive bond is gone the cement starts to dissintegrate. My intention for posting this fact is so that you and others realize that there is no dental cement that lasts indefinitely, not in the past and not in the present. Some dentists (very few from my experience) still use the older form of cementation simply because that is the material that they prefer to work with, but it has nothing to do with it lasting any longer than any other one because it doesn't.

It's great that you have taken good care of your bridge and have been very careful with chewing on it! However, all teeth (bridgework included) are suppose to touch their opposing teeth when you chew. The only exception to this would be an open bite in which the upper and lower arches do not come together properly or if there was a severe overbite causing the front teeth to protrude way past the lower ones. Perhaps you have one of those conditions?

Bryanna

My dentist uses the old cement because he feels it works better than the new through his experience. It is not because that is the material he prefers to work with.

I have an overbite so that is why my bridge and the teeth it is anchored to do not touch any other teeth when I'm chewing or otherwise. Guess I am lucky about that.

I am under no illusion that my bridge won't give out one day. But I frankly love the 48 years I have had so far with it and no trouble.

Everyone's mouth is different and others will have to do what they have to do and frankly I never ever heard of bridges being recemented every 10-15 years until the beginning of this year. That costs a bunch of $$$$.

So thank you and I will stick with what I am doing. I am lucky at that to have saved a ton of money by not "having to recement" my bridge. And again, I am under no illusion that it will last forever. But hey, 48 years is good