Immediate Implant Bridge Lower Jaw Front Teeth

This patient had a very nice dental reconstruction with many crowns. In fact I treated this patient about 8 years ago. His lower incisors were jeopardized prior to me treating him as they were really weak but he wanted to save them with regular crowns.

One of them broke off level top the gum necessitating replacement. The rationale for treating these very skinny lower incisors with dental implant is that implants cannot be too close to one another. Implants are best with space between them in the bone.

There is a high likelihood of the rest of the incisors going bad. Those small four incisors are often best removing them and placing one anchor on either side with an immediate extraction, dental implant placement, bone graft and temporary bridge…all in about 2 hours!

 

This is exactly what I did with this patient. He was able to be in and out of the office in about 2 hours and leave with a decent looking lower front bridge. Teeth are very small so the temporary bridge had to be a bit bulky to prevent breakage.

You can see in the final that I used custom abutments and a screw retained restoration to replace the lower front teeth.

At no point did he ever have no teeth. He does a soft diet for about 3 months and just chew with the back teeth only until the implants integrate.

The final bridges made in zirconia with a little bit of layered ceramics on top to make it look great. The screw access holes were closed with a composite resin and that should last patient hopefully 20 years!

Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry

6 thoughts on “Immediate Implant Bridge Lower Jaw Front Teeth”

  1. Dear Dr. Amin,

    I have a round dark spot on top of my implant bridge that no amount of brushing has eliminated. The bridge was recently drilled so that a new implant crown could be adjusted for proper occlusion. The implant bridge with the dark spot is 4 years old and had no prior problems. I wear a night guard religiously. Is it possible that the dentist drilled down to the metal, and if so, is there a lasting repair for this? I’m going to see if I can get an appointment to see this dentist, but is this something that can wait? I’m nonweightbearing after foot surgery, and the dentist is 3 hours away? Thank you for your opinion.

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  2. Dear Dr. Amin,

    I have a 4-tooth implant bridge on 23 and 26. I went to the faculty practice at a dental school and the dentist drillled the bridge repeatedly to enable some new implant crowns, that they placed, to have the proper occlusion. I was looking at my implant bridge and noticed a small dark spot on the top surface. It looks like metal. Is it possible that the dentist drilled too much of the bridge? Can this be repaired? And, will the repair be lasting or just keep falling out? Is the strength integrity of my bridge now at risk? There was nothing wrong with the bridge before the alterations via drilling were made. The bridge is 4 years old. I wear a night guard religiously. I know you cannot tell without an exam, but a general opinion would be appreciated.

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  3. Dear Dr. Ramsey Amin, I have been getting dental work for implants on teeth 30 and 31. I had a bone graft where the gum was pulled to tight making my jaw pulling when chewing my food. I had to under go soft tissue surgery where they cut tissue from the roof my mouth and Sew it into my gum line and cheek, the surgery was very pain as I felt everything done to my cheek and gum line, it was horrible. It has now been three months and I am still having a lot of discomfort, I was told the gum tissue maybe a little to high and I need to wait to see if it will settles down after I get my temporaries, the tissue where I had the soft tissue surgery oddly color is white not pink.
    UCLA School Dental, they make their’er own implants. I requested screw implants because of cement implants have a larger failing rate.

    My question is I have been told from the faculty members that since I have no supporting teeth in front or the back and because they are my impact teeth.
    UCLA Dental wants to fuse my new teeth implants crowns 30 & 31 together and they want to cement the teeth in because they said because they are fusing the two teeth together like a bridge to make them stronger, so they can’t use the screw for my new implants because the screws are harder to aligned and the impact of chew would break the screw.
    I asked if I could have them screw in independently and the said no because I still would have the same problem – breaking the screws on impact.
    Lastly, I was told my new implant crowns wouldn’t have enamel all the way to the gum and then I would have metal showing in the front and back and I was not pleased with that information, I said your implant teeth are supposed to look natural like your own teeth and I have to wear provisionals for three to four months because my teeth had been missing for a long time and my jaw is not aligned and I Need to see the impact of the temporary provisionals have all my chewing because they said at UCLA Dental school when your teeth has been out of alignment for a long time it could effect you implants longevity and could fail. Thank you for you insight.

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  4. I am looking to travel to get an assessment of dental opportunities for me I need a full arch done on my top jaw. I do have one decent molar in the top jaw. The two front teeth I have are probably only going to last up to ten years if I save them with root canals and crowns. The bottom jaw has one side without molars or premolar and the other side has only one molar in back. Most of not all the front teeth could be saved but have decay. I note the importance of keeping teeth if at all possible but if they will not last then full mouth implants may be a good idea. Most of my missing molars have been gone for about 5 years so there is bone loss. My bone up front in both jaws is in relatively good condition and there is 1 tooth that I had pulled around 6 months ago so not much bone loss there. So really I am looking for a top arch…may leave back molar or maybe you need to use that healthy bone to anchor the implants…and probably implants spanning 2 or 3 teeth on one side on bottom plus a bridge making up for 2 teeth on the other side. I am looking to travel to get your opinion And do as much work as I can. I have around 12 thousand dollars cash and probably won’t qualify for a loan unless my wife can but she is Danish…don’t know about that. I expect it will cost more than 10k but I still want to get an idea of cost and what you recommend to get done. I respect your opinion and straightforward advice online. I am looking to bypass bone grafting (because of the long healing time) If I can safely do that with a good outcome long term. How long in advance so I need to book an appointment? I am planning on coming that way in January or February 2020. Thankyou!

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