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A 3 unit implant bridge to replace 4 teeth?

User Level:
Patient
Posted by: mbistro  (5 years ago)
I'm ready for my implant restoration. This is for an implant bridge for the lower anterior incisors (#23, #24, #25, #26). My implants are in #23 and #26, abutments in place ready to go. The implants were installed by a periodontist, and I now am at a dentist who will make the teeth. When he examined me, he said I would need a 3 or 4 unit bridge. I said I had 4 natural teeth there originally, so how could I possibly need just a 3 unit bridge. He told me it was a spacing issue, and the actual number of units will be decided by the dental lab. The lab will start with solid block of zirconia, and craft the bridge using a CAD/CAM system. Further information is that he will trying to do a screw-retained bridge, avoiding cement if possible. Is it true that sometimes they can only fit a 3 unit bridge where 4 natural teeth used to be? If so, how common is this?
User Level:
Dentist
I'm ready for my implant restoration. This is for an implant bridge for the lower anterior incisors (#23, #24, #25, #26). My implants are in #23 and #26, abutments in place ready to go. The implants were installed by a periodontist, and I now am at a dentist who will make the teeth. When he examined me, he said I would need a 3 or 4 unit bridge. I said I had 4 natural teeth there originally, so how could I possibly need just a 3 unit bridge. He told me it was a spacing issue, and the actual number of units will be decided by the dental lab. The lab will start with solid block of zirconia, and craft the bridge using a CAD/CAM system. Further information is that he will trying to do a screw-retained bridge, avoiding cement if possible. Is it true that sometimes they can only fit a 3 unit bridge where 4 natural teeth used to be? If so, how common is this?

Yes, if the lower incisor teeth were crowded before, we often put 3 lower incisors where 4 were originally. Most appreciate having 3 straight incisors rather than 4 crooked ones.

It sounds like you are going to a very good dentist if they are trying to do a screw-retained bridge. Zirconia is more opaque and slightly less pretty than other porcelain systems, but wins hands-down in the strength category.
Posted 5 years ago
User Level:
Patient
Posted by: mbistro  (5 years ago)
It's a psychological barrier, the idea of seeing 3 teeth where 4 have always been. I believe we're talking about a 3 unit bridge having one pontic, OR a 4 unit bridge having two pontics, correct? And if the lab can only make 3 teeth, what do they do? Divide the space by 3, making each tooth 1&1/3 the original size? Or is the single pontic slightly wider than the crowns? If you have any 'after' photos of a case similar to mine, I would appreciate your posting them here. Yes, he does seem to be a good dentist, I've only met him once, but he was recommended by my periodontist. Thank you for your response(s), I'll feel a little better going to my impression appointment next week.
User Level:
Dentist
It's a psychological barrier, the idea of seeing 3 teeth where 4 have always been. I believe we're talking about a 3 unit bridge having one pontic, OR a 4 unit bridge having two pontics, correct? And if the lab can only make 3 teeth, what do they do? Divide the space by 3, making each tooth 1&1/3 the original size? Or is the single pontic slightly wider than the crowns? If you have any 'after' photos of a case similar to mine, I would appreciate your posting them here. Yes, he does seem to be a good dentist, I've only met him once, but he was recommended by my periodontist. Thank you for your response(s), I'll feel a little better going to my impression appointment next week.

I have put 3 incisors in. In a patient with too much space, I even put 5 incisors in. Both results were beautiful, and in neither case would anyone look at the patient and notice there was an oddball number of lower incisors. Sorry, I don't think I have any photos of these unusual cases.

If you really are doubtful and want to be reassured, he could fabricate a CAD-CAM temporary and let you wear it for a while. This will cost you extra money. If your dentist in good in Photoshop, he may be able to create one pontic versus two ponic visualizations.
Posted 5 years ago
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