Dental Work... Bridge vs. Implant

[snoopy7548]

So earlier in the year I cracked a root-canal'd tooth while eating, and ended up getting it pulled three months ago. It's a first upper molar. My treatment plan suggested an implant and possible sinus lift, so I was all ready for that.

I had a follow-up appointment last week and everything is healing nicely. After reviewing the latest 3-D scan, the periodontist said the sinus lift would be necessary and fairly complicated. My sinus cavity dips down quite a bit just around that one tooth (lucky, huh?), so roughly half of the implant would extend into my sinus cavity. He said we can make it work, but it's going to be pretty invasive and not an absolute guarantee that it would work out.

He recommended a bridge rather than an implant, especially since I do have good hygiene and wouldn't slip on keeping it clean. I'm still thinking through it, and I plan on getting a second opinion, but I was wondering if anyone here went through the same thing.

My major concern with the bridge is modifying two healthy teeth just to accommodate one bad tooth. If something happened to one or both of the now-crowned teeth (like cracking it while eating...), I'd basically be out of options. I feel like if I went the bridge route, even if it works out well, I'd always have that nagging thought of whether the implant would have been a better choice, especially since I'm relatively young at 38.

There is also the chance that the implant could fail, but in that case I'd really only be out the money and time/pain of all the procedures associated with it - I could always fall back on the bridge in a worst-case scenario. Regardless of what I choose, I want the most permanent option. I'd rather deal with implant-associated procedures now, than get a bridge now and risk having to get more implants or modify more healthy teeth when/before I'm in my 60s.

Any advice?

 

[balloonshark]

Since it's a molar, which one is going to stand up to eating various foods the best? I have a Maryland bridge on one of my front teeth and I try to be careful when taking that first bite of food. I avoid biting foods like apples using my front teeth. I guess if it falls out I can get it fixed but I bet it's expensive and I have no dental insurance. I also have to use a 'plastic sewing needle' that you have to thread floss in the 'needle' eye hole so I can clean above the fake tooth and around its sides.

Bridge Aid Threaders: https://www.amazon.com/Bridge-Aid-Threaders-Packs-Each/dp/B00EB05ITI/

Bridge types: https://my.clevelandclinic.org/health/treatments/10921-dental-bridges

 

[snoopy7548]

The implant would certainly be better in regards to strength. After considering it, I'm leaning towards the sinus lift and implant route even though the healing process will suck. I'll hopefully only have to do this once.

I've read they don't do Maryland bridges anymore, either crown-supported or implant-supported bridges.

 

[BonzaiDuck]

I was born with very good teeth, but furchrissake -- I'm 77 years old and I've cracked a lot of nuts and chewed up too many ice cubes. And for a few years after the millennium, I stopped taking care of my teeth.

I have about five implants. For the first one, I'd temporarily switched dentists and the new one didn't know what the f*** she was doing. The implant didn't "take". Apparently, the preparatory bone graft failed. But it was then repaired and done properly by another dentist who knew his business, specializing in implants.

Since then, I had a few more as I suggested. I blush and fross daily, and don't expect any more before I punch my ticket into the next life.

I had an opportunity -- a choice -- to have a bridge installed and after listening to how it's done, I chose to get another implant.

Over the last 7 years, implants have cost me about $3,000 each -- including the initial extraction, the bone graft and subsequent work before the final crown is screwed into position. I would recommend an implant over a bridge.

My departed Moms who punched out last October was having problems with her teeth before the technique of implants had been well defined. She just had all of her teeth removed, so that she used an upper and lower denture. In her last years, she couldn't chew pieces of tender steak. She could only eat soft food. And sometimes, for cleaning, I couldn't easily remove the dentures from her mouth. It was very tricky.

If I'm ever bedbound with terminal dementia, I would prefer having most of my real teeth, or at least implants. If you find yourself losing most of your teeth, you can have a "four-by-four" -- eight implants that hold an entire set of false teeth.

 

[esquared]

^^^ "
I have about five implants. For the first one, I'd temporarily switched dentists and the new one didn't know what the f*** she was doing. The implant didn't "take". Apparently, the preparatory bone graft failed. But it was then repaired and done properly by another dentist who knew his business, specializing in implants.

Over the last 7 years, implants have cost me about $3,000 each -- including the initial extraction, the bone graft and subsequent work before the final crown is screwed into position. I would recommend an implant over a bridge."

The price of your implants seems to be a good price. Not counting the one who you said didn't know what she was doing. How much did the crown for your implant cost?

I had one implant last year. My molar had a cracked root that couldn't be fixed. The oral surgeon who did it removed the tooth and I needed some of that bone graft material to strengthen where the implant would go. The extraction was 300.00. The bone graft done at the same time as the exaction was 600.00. Three months wait to see if the bone graft
took. Then the implant was 2500.00. After the implant was deemed to be good I then went to my dentist to get the crown. Another 2400.00.
5800.00 for a single tooth.

The reason I say this is because I see on TV and newspaper ads for dentists doing implants for 2,000. Now I am sure that doesn't include extraction and
the need to bone graft and definitely not the crown.
My experience is spend the extra money if you need to find a dentist you trust. I would never go to a dentist that advertised in a newspaper. I need to have one that's
been recommended, by my friends or my own dentist ( who retired 6 years back).

Bay area is expensive so I am probably paying more than in other areas.
But here's one I goggled from Texas that looks to be around 4500 for what I had done.

What is the Average Cost of a Dental Implant?

Custom Dental of McKinney provides quality dental care and Invisalign® clear aligners to patients in McKinney, TX. Call today to schedule your appointment with Drs. Bryce Gates,or Nigel Kasali!

www.thedentistofmckinney.com

 

[WilliamM2]

The price of your implants seems to be a good price. Not counting the one who you said didn't know what she was doing. How much did the crown for your implant cost?

I had one implant last year. My molar had a cracked root that couldn't be fixed. The oral surgeon who did it removed the tooth and I needed some of that bone graft material to strengthen where the implant would go. The extraction was 300.00. The bone graft done at the same time as the exaction was 600.00. Three months wait to see if the bone graft
took. Then the implant was 2500.00. After the implant was deemed to be good I then went to my dentist to get the crown. Another 2400.00.
5800.00 for a single tooth.

A little higher than here. I had one done last year, finished this year, here's the breakdown (#30 lower molar):

Oral Surgeon,
Panoramic film $130
Extraction $335
Bone Graft $550
4.5 months healing.

Then the implant was $2160. Total $3150 for the implant all in. 4 more months healing.

Then back to the dentist, crown was $2078. He doesn't make these in the office, and the first one didn't fit, so another two weeks. $5228 , and 10 months for one tooth.

My insurance considers implants "cosmetic", so it was all out of pocket.

 

[BonzaiDuck]

A little higher than here. I had one done last year, finished this year, here's the breakdown (#30 lower molar):

Oral Surgeon,
Panoramic film $130
Extraction $335
Bone Graft $550
4.5 months healing.

Then the implant was $2160. Total $3150 for the implant all in. 4 more months healing.

Then back to the dentist, crown was $2078. He doesn't make these in the office, and the first one didn't fit, so another two weeks. $5228 , and 10 months for one tooth.

My insurance considers implants "cosmetic", so it was all out of pocket.

[Also for esquared]: I thought for sure that I got the entire enchilada, including the crown, for just over $3,000. Well -- let me look at the receipts in my document archive . . . . jusaminute -- Wey-ull -- I was "on top" of my charges and treatments over years from 2017 to 2021, but I've lost track of some billings for parts of the implant process. What I find is that the initial prep -- extraction, bone-graft, and the titanium screw -- to be evaluated after some period of time before adding the crown -- was about $1,968. The final work with the crown added another $1,000. Equally, I was informed by the "temporary" dental office that the overall charges per implant were just in excess of $3,000.

But don't count on me here for accuracy. An implant, the entire process of it, takes about six months as I recall. So putting together billings I received three and four years ago to get a truly reliable estimate of the entire implant costs is difficult. When I filed the PDF scans, I did it by year for tax purposes, and implants would span two different tax years. To get to the very bottom of it, it could take me the good part of a day, so I'm just not too hopeful about all that.

My first implant occurred with the temporary dental office to which I'd switched back in 2017. Over about three years, tracking all of my fillings, crowns, and the implant work, I noticed that the number of fillings and annual expense was too high with the second (temporary) dental office. With my old dentist, we caught them recommending unnecessary work. My old dentist told me it would've been malpractice if the other dentist had gone through with it. So I re-established my relatiionship with my long-time family dentist.

Something else about my long-time family dentist. My now-departed brother had needed extensive dental work back around 2014. Another local dentist wanted $20,000 + to have it done. I told my brother to use my dentist, who gave us an estimate of about $8,500.

Paul has always been more than reasonable in his charges. He works weekends, telling me that his social life is mostly confined to his patients. He makes less than half the income that his colleague (not the rip-off dental outfit) makes.

I acquired dental insurance around 2020 as I switched back to my long-time dentist. The outfit that had been ripping me off didn't accept any dental insurance, and we concluded that this was deliberate to avoid oversight by insurers in the matter of "necessary" procedures.

 

[tcsenter]

At this time, proper bridges are still lasting a bit (on the average) longer than implants, which WILL eventually (albeit) start to have bone retreat and migration. Implants last about 10 years before needing some kind of revision. My moms just had her Maryland bridge revised after 20 years. It could have been done a few years prior but she found reasons, hemmed and hawd not to do it until it actually broke. I know people who were "ideal candidates" for bridges who had nothing but problems, and others who were "ideal candidates" for implants who have nothing but problems.

 

[WilliamM2]

At this time, proper bridges are still lasting a bit (on the average) longer than implants, which WILL eventually (albeit) start to have bone retreat and migration. Implants last about 10 years before needing some kind of revision.

Have a source for that? Implants can last up to 30 years, bridges usually need repair in 5-15 years from my research at the time.
I personally know several people with 20 year old implants.

Also, if it's a very back tooth, there is no bridge option.

Dental Implant vs. Bridge: Pros, Cons, and Which to Choose

Dental implants and bridges are two options for replacing a missing tooth. Here's what sets them apart and how to pick between them.

www.healthline.com

 

[tcsenter]

Have a source for that? Implants can last up to 30 years, bridges usually need repair in 5-15 years from my research at the time.
I personally know several people with 20 year old implants.

No source, other than I don't know anyone who is truly happy with their implants or hasn't begun to have some problem after 10+ years. That's a very limited sample size, and may have as much to do with (perhaps) lesser expert smaller town dental professionals.

Also, if it's a very back tooth, there is no bridge option.

Dental Implant vs. Bridge: Pros, Cons, and Which to Choose

Dental implants and bridges are two options for replacing a missing tooth. Here's what sets them apart and how to pick between them.

www.healthline.com

It's a problem for implants, too. Implant failure rates highest in the back, particularly mandibular.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774056/

 

[WilliamM2]

It's a problem for implants, too. Implant failure rates highest in the back, particularly mandibular.

From your link:

Mandibular posterior showed 3.3% implants failure, maxillary posterior revealed 2.2%, maxillary anterior showed 2.1%, and mandibular anterior showed 1% failure rate

3.3%? Sounds pretty good to me. And like I said, for a very back tooth, it's the only option, no other tooth to attach a bridge to.

Another tip, only have it done by an oral surgeon.

There are dentists in my area that will extract, implant, and crown all in ONE visit. These have the highest failure rate.

My main complaint is the cost, and that most insurance consider it "cosmetic", and won't cover it. Teeth are very important to overall health.

 

[esquared]

From your link:

3.3%? Sounds pretty good to me. And like I said, for a very back tooth, it's the only option, no other tooth to attach a bridge to.

Another tip, only have it done by an oral surgeon.

There are dentists in my area that will extract, implant, and crown all in ONE visit. These have the highest failure rate.

My main complaint is the cost, and that most insurance consider it "cosmetic", and won't cover it. Teeth are very important to overall health.

Yeah only a 3% failure rate is good. That's pretty much what my oral surgeon stated. I think he may have stated mid 90's success rate overall.