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Q: Dental- Marilyn Bridge or Implant and Graf ( Answered,   0 Comments )
Subject: Dental- Marilyn Bridge or Implant and Graf
Category: Health > Conditions and Diseases
Asked by: chime44-ga
List Price: $5.00
Posted: 07 Apr 2004 17:09 PDT
Expires: 07 May 2004 17:09 PDT
Question ID: 326879
I have to get my upper front tooth(#8) replaced.  I need to get it extracted and
then decide on a Marilyn Bridge or implant to replace the permanent
tooth.  Which is better?  Also, since my bone above the tooth has
deteriorated, I need a bone graf but is that only for the implant?  Do
I get the bone graf too if I just replace the front with a Marilyn
Bridge;I was told that I wouldn't need the graf since only an implant
would stimulate it.  But then won't I have a hole in my gum without
the graf with a bridge.  I do not understand when it is necessary to
get this bone graf.  My bone above the tooth is almost gone per
dentists and xrays.  Confused
Subject: Re: Dental- Marilyn Bridge or Implant and Graf
Answered By: crabcakes-ga on 07 Apr 2004 18:41 PDT
Hi chime44,

You have a touch decision to make!  I won?t be able to tell you which
choice is best for you-but I have provided you with plenty of
information to enable you to make an informed decision. When trying to
decide which dental procedure to select, you will need to take into
consideration the cost, your age and your general health. An implant 
appears to be more expensive. The average cost of a dental implant is
$1,800, depending on your situation, and this is without the cost of
the bone graft.

You say that the bone above the bad tooth is ?almost gone?. I?m not a
dentist, but it sounds like your dentist is saying that for whatever
reason, your jaw will not support an implant without a bone graft.
He/she is assuming a bone graft will strengthen the jaw enough to
support a dental implant. It?s possible for periodontal disease to
cause surrounding bone to erode. Should you decide on a bridge, you
don?t need to worry about a ?hole? where your tooth was. Once the
tooth is extracted, the gum tissue will fill in the hole. It will be
important to your overall dental health to have a bridge installed,
(or an implant, if you decide to go that route) to prevent shifting of
other teeth.

According to Dr. Sheldon Seidman: ?If the missing tooth space has no
surrounding teeth, the dentist may decide a dental implant is the most
appropriate choice.?

If you are a diabetic, have heart disease, are on coumadin (blood
thinners), prone to infection, have a thyroid  disorder, adrenal
problems, or certain forms of gum disease, you will not be a good
candidate for an implant. One implant in 20 is rejected, and this may
be higher in smokers. 90% of dental implants last 5 years, 85% last
between five and 10 years. About 75% survive last 10 years, although
this has not been well studied. Your dentist should cover all of these
factors with you, and she/he can decide if you are truly a candidate
for an implant.

A Maryland bridge, simply described, is a false tooth (called a
?pontic tooth? in dental terminology) that is fused to a metal band.
This band is then cemented to the teeth on both sides of the false
tooth, in the back, so the band is invisible when the mouth is open.
This is a very commonly used type of bridge when the front teeth are
involved. The surrounding teeth are ground down a bit, so that
porcelain crowns can be put on. With proper care and hygiene, most
bridges of this kind last 8-10 years. A dental bridge can maintain
good oral health - it keeps other teeth from shifting to fill the gap
left by a missing tooth. ?Dental bridges can last 5 to 7 years and
even longer. With good oral hygiene and regular prophylaxis, it is not
unusual for the life span of a fixed bridge to be over 10 years? Since
you apparently DO have teeth surrounding the missing tooth area, you
are a good candidate for a Maryland bridge. You do NOT need a bone
graft to have a Maryland bridge installed. The surrounding teeth, and
the cemented band will support the false tooth.

This page illustrates the preparation of the teeth that will be on
either side of the false tooth, in a Maryland bridge:

I was unable to find the cost of a Maryland bridge, but by looking at
this Cigna Dental re-imbursement document, I would say the cost of a
bridge may be lower than an implant.

?The Maryland Bridge is an ultra-conservative treatment option that
enables the dental practitioner to splint or replace missing teeth
esthetically, with an absolute minimum amount of tooth modification.
This type of bridge combines a composite resin cemented to acid etched
enamel and an acid etched cast metal framework. The Maryland Bridge
improves the bond strength of the restoration three-fold over earlier
perforated resin-bonded retainers.
With the Maryland Bridge, fixed partial dentures, periodontal splints
and a variety of other conservative restorations can be placed with a
minimum of tooth modification. Abutment teeth are basically left
intact and not damaged?
Dental Find

From the University of Maryland web page, some tips for maintaining the bridge:

·Brush your teeth carefully after every meal with fluoride toothpaste
and a soft-bristled toothbrush, as food may become lodged causing the
gums and teeth to become infected. This may lead to further
complications resulting in the loss of the bridge.
·Floss daily. Your dentist, or other oral health specialist, may
recommend using a floss threaded for hard-to-reach places between the
bridge and its adjacent teeth.
·Have your teeth cleaned every 6 months by an oral health professional. 
·Limit your sugar and starch intake, as debris left behind from these
types of foods may turn into damaging acids, which, in addition to
promoting plaque formation, may also be harmful to teeth and gums.
·Avoid hard and/or sticky snacks. This includes foods such as popcorn,
hard or chew candy, caramel, and/or nuts.
University of Maryland

Illustration of a Maryland Bridge. Hover your cursor over the
multi-colored ?stars? in the upper right hand corner of the graphic to
see the names of each section.

Discuss all your concerns with your dentist to come to an informed
decision. Take into account the cost, and more importantly, your
overall health!  If you don?t feel comfortable with your dentist,
don?t be afraid to seek another dentist! One more thing?if you are
prone to infection, and/or the bad tooth is infected or abscessed, you
may want to consider some antibiotic therapy before and after the

Hope this helps you in your decision! If any part of my answer is
unclear, please request an Answer Clarification, before rating.


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