Lava crowns and bridges?

eth0_

I had a molar tooth out last week (the 2nd from the back on my lower jaw), and my dentist has suggested a bridge or an implant once everything has healed.

I notice she is now offering 'Lava bridges'. Is there much advantage over conventional bridges? I have a maryland bridge already and am really happy with it - you wouldn't think it wasn't my real teeth - so is it just a cosmetic upgrade to a normal bridge?

Is there any reason to go for an implant over a bridge for this tooth?

btkm8unsl0w5r4

Your own dentist (in Newry) should really explain your options to you for your own particular case.

Lava bridges are made from a white poly crystal called zirconia (YTZP to be precise). It is a strong ceramic core which is layered with ordinary dental ceramic to look like a tooth. Metal ceramic bridges are more common and use an alloy to reinforce the layering ceramic. There are long and boring reasons why zirconia bridges are currently a bad idea especially in high stress areas at the back of the mouth. Less experienced clinicians over prescribe these because they can market them as "new" and more "aesthetic" (at the back of your mouth?) however the zirconia is so white it causes more problems than it solves. Its not that they are bad bridge just that to disadvantages of them still outweigh the advantages to my eye.

In this age of so called "cosmetic dentistry" (where are the uncosmetic dentists?) the pursuit of new white restorative materials is driven by marketing forces and not long term clinical trials. In the mouth the tried and tested materials are usually the best and often most aesthetic.

Implants are always a better idea if you have the bone left and money, cause they don't join you teeth together and have better long term (15 years +) prognosis. However if i were having a metal cylinder screwed into my jaw bone I would be very sure the person doing it knew what they were doing.

Your own dentist should take the time to explain what options are best for you.

Replacing all missing teeth (apart from wisdom teeth) is usually a good idea.

eth0_

Braylee Gorgeous Matte wrote:

Your own dentist (in Newry) should really explain your options to you for your own particular case.

She didn't recommend the lava bridge to me (I read a leaflet about Lava in the waiting room), she told me I would need "a" bridge or an implant in there or the teeth either side could shift, or the corresponding one on the upper jaw could descend (I forget the word she used). She said she would explain the options and let me decide when I come back in 3 months when everything has healed up.

Braylee Gorgeous Matte wrote:

Implants are always a better idea if you have the bone left and money, cause they don't join you teeth together and have better long term (15 years +) prognosis. However if i were having a metal cylinder screwed into my jaw bone I would be very sure the person doing it knew what they were doing.

In a way I would prefer an implant, however I am really squeemish even thinking about it. I'd be referred to a specialist in implants if I decided to go with this option. I presume it's not particularly painful having the peg fitted but is there much pain following that procedure when everything is healing up?

lomb

eth0_ wrote:

She didn't recommend the lava bridge to me (I read a leaflet about Lava in the waiting room), she told me I would need "a" bridge or an implant in there or the teeth either side could shift, or the corresponding one on the upper jaw could descend (I forget the word she used). She said she would explain the options and let me decide when I come back in 3 months when everything has healed up.



In a way I would prefer an implant, however I am really squeemish even thinking about it. I'd be referred to a specialist in implants if I decided to go with this option. I presume it's not particularly painful having the peg fitted but is there much pain following that procedure when everything is healing up?

good implant surgery is painless or as close to painless as possible. i placed a few recently and patients commented they felt less than having a tooth out. rember the bone starts disappearing at 3+months and to have one placed as soon as possible as the long term success (for the rest of your life)is far higher when the bone plates surrounding it are thicker or placement into grafted bone. bridges are no longer a good idea in the eyes of many in the profession and fail catastrophically in 10 -15 years taking out the abutments. the only bridges ive seen last for 30 years are those where the margins rest on enamel are imperceptable to the tooth , the teeth either side are resonably parallel so that parallism isnt gained at the expense of preperation, the abutmebnts remain alive(usally a function of closed margins, removal of all decay, good cement and the way the stars line up)and the patient maintains good oral hygiene with interproximal brushes. that is alot to ask for, but it is possible! also lava bridges tend to lead to thick overhanging margins unless the preperations are overreduced that then compromise the nerve and strength of the remaining tooth. they can be used sucessfully for bridges at the front of the mouth though, but the preperation required on premolars or molars is unthinkable. they are also very difficult to cut off if they need removal later. porcelein fused to metal ideally to a high gold content metal on short bridges is still the best long term option. hope that helps.

eth0_

Hmm I think i'll be going for the implant then, especially as it's a grinding tooth and will have to withstand more pressure.

With bridges, is it a good idea to have the bridge taken off every few years, and the teeth (abutements?) underneath checked out for decay, or maybe just an x-ray of the area?

btkm8unsl0w5r4

An implant is usually supprisingly painless, the problem is not getting the implant in the jaw its getting it in the correct position to put a nice tooth on it because once it is healed in place its there forever. The more time that passes after your extraction the more the bone in that area will disolve particuarly in the first 6 months. Sometimes a bone graft is needed but not always.

lomb

eth0_ wrote:

Hmm I think i'll be going for the implant then, especially as it's a grinding tooth and will have to withstand more pressure.

With bridges, is it a good idea to have the bridge taken off every few years, and the teeth (abutements?) underneath checked out for decay, or maybe just an x-ray of the area?

bridges are seated usually with permanent cement so as to reduce bacteria getting in and killing of the nerve/ decay. so theres no getting them off easily. xrays are definately a good idea every few years. the problem with crowns and bridges is one cant see through the crown on an xray as it blocks xrays so cant detect decay inside the crown. luckily decay can be spotted under the margins where it meets the tooth. hope this helps.

eth0_

Cheers lomb, that's very helpful.

How come xray's can't get through crowns?

Big_G

Because the materials used to construct them are generally too dense to allow the x-rays to pass through. They are absorbed or reflected by the material instead.