Looking for a second opinion mortgage on tooth situation.

Posted by admin on July 26th, 2007 at 12:35pm

Q. Looking for a second opinion mortgage on tooth situation. Any information?

A. First, I’d have to look at diagnostic casts to see if the teeth on the right side your mouth have shifted over to the left to close that space. Does the midline between your two front teeth lie perfectly in line with the center of your nose? It looks to me like the midline is not centered and has shifted around to the left side towards the space. The problem you are going to have is anything you do with that space without ortho, will lead to several teeth on that side that are quite a bit narrower than the same teeth on the opposite side. That’s one of the reasons I don’t favor the bridge. As for your question: Sure you could extract #10 and 11 (the two teeth you mention) and replace them with implants. However, there are three large problems: 1) the teeth are going to look awfully narrow, 2) it’s never a good idea to remove a cuspid (#11), and 3) maintaining esthetically acceptable tissue height and papillae may be a problem with two adjacent implants. I’d go the ortho route first. If the lingually displaced #10 (the crooked one) can’t be brought back into alignment with braces, then extracting it and replacing it with a single dental implant is definitely a possibility after the ortho. An alternative treatment, but waaaaaaay down on my list of acceptable treatment after the ortho, would be to extract #10, and do veneers on 6,7, and 8, and an all-ceramic bridge from 9 to 11. This way, the lab can share the lack of space across six teeth, thus making all of them appear to be the same width. Unfortunately, at your age, all of that work will likely need to be redone a couple of more times in your lifetime (veneers and bridges fail eventually). That’s why I like the ortho idea…and implant #10 if necessary…once it’s done, you may never have to undergo another procedure up there ever again. .

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