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Julian Chen
Julian Chen, Dentist
Category: Dental
Satisfied Customers: 559
Experience:  Practicing General Dentist since 2002
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I have a 3 teeth bridge (front) being held by two real teeth

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I have a 3 teeth bridge (front) being held by two real teeth on each side. Unfortunately, I broke the two real teeth so my dentist has given me the option of a post and core procedure for both teeth and then re-do the bridge. I am concerned that the post and cored teeth will not be strong enough to hold the bridge. The other option is to extract both teeth and put implants in place of them and then put the bridge but this is an expensive proposition for me. The third option is to maybe post and core the two real teeth and then put a removal denture for the three missing ones until I can afford implants for them. What is the best option for me at this point?
Submitted: 4 years ago.
Category: Dental
Expert:  Julian Chen replied 4 years ago.
I am assuming that with the bridge that broke, the two supporting real teeth have already had root canal treatment done to them? Else, there would be no way to place a post and core for them prior to redoing the bridge.

And if my assumption is correct, that those 2 teeth have already been root canal treated, then those two teeth are definitely less-than-ideal candidates for redoing the bridge. The reason is because root canal treated teeth become more and more brittle with time. The longer/older the root canal treatment, the dryer the teeth becomes. So although the post and core will allow us to build a bridge over the existing tooth structure, if you're not very careful (as in avoid biting into apples, corn on the cobs, etc...) you are very likely to end up with a root fracture and those teeth will need to be extracted. In short, I would be hesitant to redo the bridge since if one tooth breaks, then the whole thing needs to be replaced.

So here are your options:
1) Post and core on both teeth and redoing the bridge. (Not my #1 recommendation.)
2) Extract both teeth and restore with an implant 3-unit bridge. (Very expensive)
3) Post and core both teeth and crown them individually, then restore the missing tooth with a removable denture until you can afford "implants" for them. (Sounding like a possible option)

But what about option #4?
4) Post/core both teeth and crown them individually. And place a single implant where the missing tooth is?

With option #4, you separate all your restorations so that if anything happens to any one of them, you won't involve the other 2. With option #4, you only need to invest in 1 implant post and 1 implant crown (as opposed to 2 implant posts + 3 implant crowns). Granted the post and core procedure + individual crowns will not be cheap by any means, they should still be less than the extraction + implant for those teeth.

The only reason I can see option #4 not being viable is if you've lost a lot of bone in the area, making it an ineligible site for implant without first grafting the site.

Unfortunately, it's impossible for me to tell you over the internet which is the best option for you. If there is sufficient bone in the edentulous area (toothless area), then I believe #4 would be the best option. It would be a suitable compromise in terms of financial expense and durability/longevity of your restorations. By separating the 2 supporting teeth, you've greatly reduced the amount of forces placed upon each tooth. And if something were to happen years down the road, you still have the option of extraction and implant. You don't necessarily need to have an implant bridge. And in the more ideal sense, it's always better (when possible) to keep each teeth/unit separate.

Regards,

JulXXXXX XXXXX, DDS
Customer: replied 4 years ago.
I agree that option 4 is the best for me but I may have to go with option 3 for now as I actually have three missing teeth in between the two real teeth which have been root canalled in the past. Because If I go with option four l will need to pay for three implants plus the post and core on the other two real teeth which I cannot afford right now. I guess I will just have to post and core the two real teeth and then do a removable for the three front ones until I can save up enough monies to do the implant on the three missing front teeth although I may have to do grafting on these because five years ago I was told that I do not have enough bones there do do the implants right away. Thanks for your help!
Expert:  Julian Chen replied 4 years ago.
I see. When you wrote 3-teeth bridge, I took it as a 3-unit bridge. Instead, it seems that it was a 5-unit bridge that broke. If this is the case, then option 1 (redoing the bridge) is absolutely ill-advised and NOT recommended. 5-unit bridges are too long and allows too much flex. They are practically guaranteed to fail.

Sorry I couldn't give you better news on the matter. Best of luck to you.

Regards,

JulXXXXX XXXXX, DDS
Julian Chen, Dentist
Category: Dental
Satisfied Customers: 559
Experience: Practicing General Dentist since 2002
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