Dental Bridges: Do I Need to Remove the Implant Post?

I need to get a dental bridge, but the two teeth in the front and back are also prosthetic teeth. The doctor said I need to remove the dental implants as well?

Hello Doctor: Recently, it was confirmed that the root of my third upper left dental implant has fractured, so I had to have the entire tooth extracted.
The teeth in front and behind it are also implants, and I would like to have a dental bridge.
However, the doctor mentioned that if the crowns and abutments of the adjacent implants are made separately, then only the crown needs to be removed without disturbing the abutments, allowing for the bridge to be placed.
But he also said that if the crown and abutment are integrated, then the abutment would need to be removed, which I fear could damage the root! Additionally, this would increase the cost.
Therefore, my questions are: 1.
Is it true that the crown and abutment can be integrated? 2.
If that is the case, is it absolutely necessary to remove the abutment as well? Can't the crown and part of the abutment be removed using a mechanical drill, and then a new crown be fabricated? This issue is really troubling me.
Thank you!

Daniel, 50~59 year old female. Ask Date: 2020/01/30

Dr. Zeng Guanghui reply Dentistry

If the areas adjacent to the edentulous space have already been treated with teeth and dental posts, typically the crown and post are separate.
It is possible to remove the crown while preserving the existing post to fabricate a new bridge.
However, it is rare to encounter a crown and post that are integrated as a single unit.
In such cases, it is not feasible to remove both the crown and post together, then replace the post and subsequently create a new bridge.

Reply Date: 2020/01/30

More Info

When it comes to dental bridges, especially in the context of dealing with implant posts and the surrounding dental structures, there are several important considerations to keep in mind. Your situation involves a broken dental crown and the potential need to remove the implant post, which can understandably cause concern. Let’s break down your questions and provide some clarity based on dental practices.

1. Is it possible for the crown and the implant post to be fused together?
Yes, in some cases, the crown can be cemented onto the implant post in such a way that they function as a single unit. This is often done to ensure stability and longevity of the restoration. However, this does not mean that they are physically inseparable. The method of attachment can vary based on the dentist's approach and the materials used. If the crown is cemented, it can typically be removed without damaging the implant post, but this requires careful technique.

2. Is it necessary to remove the implant post if the crown is damaged?
Not necessarily. If the crown is damaged but the implant post is intact and stable, it may be possible to remove just the crown and replace it without needing to disturb the implant post. This is often the preferred approach as it minimizes trauma to the surrounding bone and gum tissue, and it can save on costs and recovery time. However, if the crown and post are indeed fused or if there is significant damage to the post itself, removal of the post may be required.

3. Can the crown be destroyed while leaving the post intact?
In many cases, yes. Dentists can use specialized tools to carefully remove the crown while preserving the integrity of the implant post. This process involves drilling into the crown to break the bond without applying excessive force to the post. However, this is a delicate procedure and should only be performed by an experienced dentist or oral surgeon to avoid complications.

4. What are the risks involved?
The primary risk in attempting to remove a fused crown and post is the potential for damaging the implant post or the surrounding bone structure. If the post is damaged during removal, it could lead to the need for additional procedures, such as bone grafting or even the placement of a new implant. Therefore, it is crucial to have a thorough examination and possibly imaging (like X-rays or a CT scan) to assess the situation before proceeding.

5. Consultation with your dentist:
Given your concerns, it is essential to have a detailed discussion with your dentist. They can provide insights based on your specific dental anatomy and the condition of the implant and crown. If you feel uncertain about their recommendations, seeking a second opinion from another dental professional, particularly one who specializes in prosthodontics or implant dentistry, can also be beneficial.

In summary, while it is possible for crowns and implant posts to be fused, they can often be treated separately. The need to remove the post depends on the specific circumstances of your dental restoration. Always prioritize communication with your dental care provider to ensure that you are comfortable with the proposed treatment plan and understand the risks and benefits involved.

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