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(2 laterals) bridges vs implants - replacing Maryland Bridges
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Jay556 posted:
I have had two Maryland bridges since I was 16. One recently fell out, but the side attached to my K9 has been loose for the last few years so I had a decent cavity which I had filled. Now I need a replacement. My other lateral (both upper lateral incisors missing) is loose on from the K9, but holding on the central.

If my bone allows, I understand the improtance and value of maintaining the intgretiy of my teeth. My dilemma...both centrals and K9's have been ground down on the lingual side due to the maryland bridges and I have a couple cracks in the central which has the current maryland bridge still intact. There is some partial nerve damage which has caused a slight greying of the tooth.

So does the condition of my central with the possible damged nerve effect how I should decide on which route to take? Your input will be greatly appreciated.
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Zev Kaufman, DDS responded:
Dear Jay556:

I just realized that your question was never answered. I apologize for that. However, I have answered this question many times before.

Nevertheless, I will give you the information you need:

Even if your teeth are somewhat prepared on the back and the grey is showing through, a composite bonding, or a porcelain veneer restoration on the back of the teeth is indicated. The greyness will also disappear.

In addition, with today's stronger porcelain restoration, a small cantilever bridge with a retentive wing on the palatal (back) side of the canines with a hanging lateral will give you a durable, long lasting and a very esthetic restoration. It is a simpler and much more "conservative" approach to the implants.

If the gum and bone are adequate for implants in the lateral positions, go for the implants and have your dentist restore the backs of the centrals and canines.

If you have issues with lack of bone, consider the cantilever bridges as I described.

If your dentist does not know how to make the bridges I have described, goto www.gotoapro.org and look up a Prosthodontist near you. The Prosthodontist is the expert in cosmetic, restorative, and implant dentistry and should be able to go over the choices with you.

Best of luck,
Dr. Zev Kaufman


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