Should You Bridge Implants with Natural Teeth? Expert Insights

Q: Should You Bridge Implants with Natural Teeth? Expert Insights

Hello： If both are implants, it is indeed possible to consider creating a dental bridge to increase load-bearing capacity and stability. <br>However, in your case, it is important to consider whether the lateral occlusion is canine guidance or group function. <br>If it is canine

Can dental implants be used to create a bridge with natural teeth?

To summarize the dental situation: The patient has a missing tooth numbered 34 and was previously advised by another dentist to place an implant for tooth 34 and create a three-unit bridge with teeth 33 and 35.
Due to reliance on these three teeth for chewing, the patient has recently experienced pain.
The current dentist diagnosed the issue as a result of different stress distribution between the implant and natural teeth.
After removing the original bridge, it was discovered that tooth 33 has severe decay, and the recommendation is to extract tooth 33 and place an implant.
However, since tooth 34 uses a different implant system than what the current dentist prefers, the current recommendation is to create a two-unit bridge between teeth 33 and 34 to avoid complications if tooth 34 has issues in the future.
The question is whether it is better to keep the teeth independent or to proceed with the two-unit bridge.

Chen Wenjie, 60~69 year old female. Ask Date: 2022/06/09

Dr. Lin Jiayong reply Dentistry

Hello: If both are implants, it is indeed possible to consider creating a dental bridge to increase load-bearing capacity and stability.
However, in your case, it is important to consider whether the lateral occlusion is canine guidance or group function.
If it is canine guidance, we need to assess whether tooth 34 can adequately support the forces applied to tooth 33.
If it is group function, we must understand why tooth 33 previously experienced caries failure and eliminate the causes of that failure to ensure that the new implants do not fail again.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2022/06/09

More Info

When considering whether to bridge implants with natural teeth, there are several important factors to take into account, particularly in the context of your specific dental situation. The decision to use a dental bridge or to opt for individual implants should be based on a thorough understanding of the mechanics of dental forces, the health of the surrounding teeth, and the overall dental architecture.

In your case, you initially had a missing tooth (tooth number 34) and were advised to place an implant there while bridging it with the adjacent natural teeth (33 and 35). However, the pain you experienced was attributed to the differing forces exerted on the implant compared to the natural teeth. This is a crucial point because implants and natural teeth respond differently to chewing forces. Implants are rigid and do not have the same periodontal ligament that natural teeth do, which can lead to uneven stress distribution and potential complications.

After the removal of the original bridge, it was discovered that tooth 33 had severe decay, leading to the recommendation for extraction and subsequent implant placement. The current suggestion to bridge teeth 33 and 34 together is intended to provide stability and distribute forces more evenly. However, this approach has its pros and cons.

Pros of Bridging Implants with Natural Teeth:
1. Stability: Bridging can provide additional support to the implant and distribute chewing forces more evenly across the bridge.

2. Aesthetic Considerations: A bridge can create a more uniform appearance, especially in the visible areas of the mouth.

3. Simplified Treatment: In some cases, bridging can be less invasive than placing multiple implants.

Cons of Bridging Implants with Natural Teeth:
1. Risk of Compromising Natural Teeth: If the natural teeth (in this case, tooth 33) are not in optimal health, they may not withstand the additional stress from the bridge, leading to further dental issues.

2. Difficulty in Maintenance: Bridges can make it harder to clean between the teeth, potentially leading to decay or gum disease in the supporting natural teeth.

3. Complicated Repairs: If the implant or the bridge fails, it may complicate future treatment options, as you may not be able to address the implant independently.

Given your situation, where tooth 33 is compromised and may need to be extracted, it is essential to consider the long-term implications of bridging these two teeth. If both teeth are healthy and can support the bridge without issue, it may be a viable option. However, if there are concerns about the health of tooth 34 or the potential for future complications, maintaining them as separate entities may be more prudent.

Recommendations:
1. Consultation with a Specialist: It is advisable to seek a second opinion from a prosthodontist or an oral surgeon who specializes in implant dentistry. They can provide insights based on the latest techniques and materials.

2. Consider Individual Implants: If feasible, placing individual implants for both missing teeth may provide the best long-term solution, allowing for independent maintenance and reducing the risk of complications.

3. Evaluate Bone Health: The condition of the bone surrounding the implants and natural teeth should be assessed to ensure adequate support for whichever option you choose.

Ultimately, the decision should be made collaboratively with your dental care team, taking into account your specific dental health, lifestyle, and preferences. The goal is to achieve a functional and aesthetic outcome that promotes long-term oral health.

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