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Ask Mark Bornfeld, DDS Your Own Question
Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5762
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA, American Academy of Oral Medicine
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I know it maybe easier in person but I would like a second

Customer Question

Hi. I know it maybe easier in person but I would like a second or thrid opinion to see if what I feel will work in my mouth i had 17 corwns, buildups, 6 root canals 3 years ago since then the bridge has become loose on rigjht side , one tooth popped off one side and two teeth popped off other side due to the lack off back teeth support when chewing/. I am getting ready to go to costa rica again and this time they financial is much higher however I feel that a alternative plan may work vs what they want to do-
I wanted to see if you think I could get flapless implants in back upperx2 one on each side, two back lower on on each side and fix bridge and possibly add fixed bridge
Evaluate the bone mass, can it be done do u think without sinus lift and mabe just bone graph> What would you do to save what I have versus go the way they want which is 4 implants add a 4 on 1 fixed bridge, sinus lift and bond graph. I can send the plan they sent as well as Panaoramic xray and real time image to
Submitted: 1 year ago.
Category: Dental
Customer: replied 1 year ago.
see images
Customer: replied 1 year ago.
here is the one plan Im trying to avoidtooth / Area
Treatment
Cost per unitGeneral
General
IV Sedation6,8,9,10,11
Extractions
No cost
No cost
UR, UL
Sinus Lift3,5,8, 10,12.14
Dental ImplantsUpper jaw
Fixed upper *temporary denture.
Customer: replied 1 year ago.
option 2Option 1: All on 4
· Monolithic zirconium bridge
· Monolithic zirconium teeth
· All done in two trips
· $15.800.00 each bridge
· $285 Initial Examination, x rays and 3D tomography.
All of our implant cases are done using the best implant brands in the world, like Zimmer, Nobel Bio Care, etc. These components give us a lifetime guarantee support that assures you excellent long term results.
For this option we will need you here in Costa Rica two times. First trip during 5 business days for the surgical procedures, then you will go home for healing process using temporary fixed teeth. The healing process takes 6 months. After this time, you come again for the fabrication of your new teeth and we will need you here in Costa Rica during 10 business days.
Customer: replied 1 year ago.
option 3Option 2: Upper restoration
First stage
Initial Examination, x rays and 3D Scan tomography
6 temporary front teeth
Build up of teeth #6 and #10
Two sinus lift, left and right
Teeth #3 and #5, dental implants
Teeth #12 and #14, dental implantsSecond stage
Teeth #3, 4, 5 Bridge of 3 units over implants
Teeth #12,13,14, Bridge of 3 units over implants
Teeth #6,7,8,9,10,11 Porcelain crowns over teeth
Customer: replied 1 year ago.
the plan I am asking if it is possible to do this in one trip using flapless implants, or do the ones needed to support the upper teeth, for if I had this support the bridge would not have broken and I would not be in this shape. it s loose on upper right side here is live image
Customer: replied 1 year ago.
expert needs to have great experience in implantology/oral surgery
Customer: replied 1 year ago.
i want to go for 8 days amd leave and no return trip needed...so option for same day loads or flapless amd fix what i have and the new implants will support it. the bottom bridge and crowns No issues/ and strong-my gums are healthy and I feel the teeth roots are good I have left
Expert:  Dr. Katz replied 1 year ago.

The panoramic image that you have posted is not of diagnostic quality to answer any of your questions.Your options rely on the amount of bone structure that is available to place implants and your financial capability to afford the very expensive treatment plans that are being offered.Without seeing a clear picture of your bone structure,it would be impossible to give you any real guidance about which option to take.Here are a couple of things to consider.Do you have periodontal disease?What was the cause of you having all of your posterior teeth removed? What is your financial limit? Have you considered removable partial dentures?Do you realize the risks of doing bilateral sinus lifts.?Are you prepared to travel back to ***** if you have any problems with the implants?Are you aware that most dentists will not want to treat the complications in the US if you have the work done in Costa Rica without charging you a lot of money if they want to get involved at all?

Expert:  Dr. Katz replied 1 year ago.

Same day loading of implants is highly discouraged.You are taking your chances with no warranty on any of these type of implants.If the implants are placed under load without letting them osseointegrate into the bone,your chances of success and longevity are greatly reduced.

Customer: replied 1 year ago.
i WILL HAVE to totally disagree with your opinion and concern regards ***** ***** Rica Dental facilities and surgeons, the USA dentists are far too overpriced and the demand is great which is why medical tourism is booming. I have over a dozen friends who have had incident free dental and mine is due to having zero support in back, the US dentist I saw applauded the costa rican dental work saying it was some of the best hes seen- The panoramic was used by 3 others, what is wrong with being able to see bone structure? Cant it be seen clear?
Customer: replied 1 year ago.
real time
Customer: replied 1 year ago.
You failed to mention flapless implants- That option has good success and almost painless correct? So my collegue had them
Customer: replied 1 year ago.
Its sad the medical world in USA has to be so pricey for whatever reason, the supplies cost the same, and the quality over there is the same. I was told this by a US dentist regards ***** ***** crowns. I had 5 or 6 root canals plus all you see for less than 5k. I could not even get two root canals for that here which is sad
Expert:  Dr. Katz replied 1 year ago.

I made no mention about the quality of care in Costa Rica if you read my response.The panorex X-ray is of poor quality and the bone structure especially in the sinus area is not visible.You have not answered the questions that I have presented and you seem to have it pretty firm in your mind what you want to do.Again ,no mention was made of dental facilities or surgeons in Costa Rica.That is something that you added yourself.Remember that every case is different .Just because your friends had a good result,they may not have the same lack of bone structure and missing teeth that you have.Genetics plays a big part in the success of a case like this.The research on flapless implants is limited and long term studies on flapless implants are not available.The short term studies show that the complications are equal to nonflapless implants and no statistical differences exist.