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Post by jeffolie on Feb 15, 2013 9:03:33 GMT -6
Please advise me about dental implants for 2 molars, #'s 18 & 19.
My underlying molar number 18 has split requiring extraction. This supports a bridge attached to a tooth. To avoid damage to the attached tooth, the bridge needs to be cut ... dentists call this cutting, 'sectioning'. The split underlying number 18 will be removed, extracted.
2 molar spaces then would be refilled with implants.
Dental implants are now considered 'cosmetic' because a 'partial' could be used, a denture for the empty space for the 2 molar spaces. Partial dentures often lead to future difficulties.
I have begun the process of getting 'complementary' consultations for all the work: sectioning the bridge, extraction of number 18 and implants for 18 & 19.
Please advise me !!!!!
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Post by jeffolie on Feb 15, 2013 9:54:04 GMT -6
The only consultation, estimate I currently have for the work was about $7000 ... I have a few scheduled
Has anyone known of difficulties associated with the currently inserted dental molar implants or other thoughts on this decision I must make ?
At a minimum the bridge must be cut and molar 18 removed, extracted ... beyond this minimum, I have choices and decisions to make.
Please advise .....
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Post by jeffolie on Feb 15, 2013 16:22:11 GMT -6
An oral surgent today consulted offered to perform a longer bridge without any implants ... spanning over the molars 19 and soon enough to extracted molar 18 ... anchoring from the wisdom tooth[20] to 17. I negotiated a price of $2117. I did not commit to have this done by only committing to consider this offer.
Now I am confused. My general and primary dentist did not offer this longer bridge ... I will have to consult with my general and primary dentist to discuss this long bridge option.
I discussed bridges with my DHMO, United Concordia. They added to the confussion by stating they would only pay for the lowest, "Base" option of 3 options recommended by my general and primary dentist. This drives me back to my general and primary dentist to suggest that a Partial not be included among the 3 options. Without my general and primary dentist's making 3 options of bridges or more expensive choices, I will be only covered for a Base option which would be a partial.
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Post by jeffolie on Feb 16, 2013 11:14:18 GMT -6
Yesterday, the consulted dentist stated that if I selected getting implants for molars 18 & 19, then I would need bone grafting after extracting molar 18 and not need bone grafting for the existing bone where molar 19 previously was extracted many years ago. No bone grafting would be needed if I went with yesterday's consulting dentist offer to install a long bridge even though molar 18 would be extracted.
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Post by danreller on Feb 16, 2013 17:12:59 GMT -6
Jeff, it sounds like you have an existing bridge from #18 to 20, #19 being a pontic (replaced tooth). Your wisdom tooth #17 is also present. #18 needs extraction compromising the bridge.
Without seeing X-rays and an intra-oral exam the following is only conjecture. Here are possible courses of treatment: 1. Section the bridge at the Distal (posterior side of #20) making it a “crown only” if possible (depends on the design of the bridge, but from what you have described with the other treatment possibilities described by other dentists, can be done). Don’t do anything to spaces #s 18 and 19. Depending on the other parts of your mouth, you may function at the same level. Tooth movement over time and super eruption of the opposing arch (Uppers) could be a possibility 2. Bone augmentation of space # 19, implants for 18 and 19, then crowns for 18 and 19. This is probably the most expensive and time consuming route, but could yield the best results. 3. A removable partial denture for spaces 18 and 19. If you are not missing teeth in the lower posterior on the contralateral side (right side) then you would need a “one-sided partial”. Lower partials are very hard to wear with many people end up not using them. One-sided lower partials are even more apt to not being used. 4. A bridge from #17 to 20. Without being able to actually examine you, there is a high likelihood that the span is too great for long term success. The span would be the width of 2 molars using a wisdom tooth (usually with less root surface than 1st or 2nd molars and using a bicuspid (again with less root surface than the molars they will be supporting). If #19 was lost early and #s 17 and 18 have drifted forward reducing the span, it could still be a viable consideration with good success. 5. Your general periodontal (gums and supporting structures) condition could also be a consideration in the course of treatment.
Sincerely,
Dan
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Post by jeffolie on Feb 22, 2013 9:53:00 GMT -6
My comparison shopping has provided a wide experience of presentations by Oral Surgeons and a variety of points of view.
Some have promoted a long bridge as an adequate choice compared to implants because of the significantly lower total costs plus the significantly shorter healing period: 1. healing period: long bridge about 3 weeks vs implants ranging from 3 mos to 1 year 2. lower costs: the lowest decent 4 tooth, 4 crown bridge $2115 vs implants $3365
My comparison shopping continues with additional consultations scheduled for Saturday through Tuesday.
Findings: 1. snobby, high end oral surgeons prices range about $9000 for implants, $6000 for a long bridge 2. middle class oral surgeons prices range about $6000 for implants, $4000 for a long bridge 3. value oriented oral surgeons prices range about $$3400 for implants, $2115 for a long bridge 4. low end oral surgeons prices range about $2700 for implants, $2000 for a long bridge
my jeffolie view: implants at a marginally higher cost exceed the economy of a long bridge.
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Post by jeffolie on Feb 23, 2013 15:16:41 GMT -6
I selected an oral surgeon, started the process to get 2 implants. I had the bridge section removed and an extraction today.
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Post by jeffolie on Feb 23, 2013 17:48:59 GMT -6
No, my dental insurance did not pay for what I selected nor the extraction.
The insurance which I do have does not cover implants nor this particular bridge because it would only pay for the least costing alternative which in my situation the least costly alternative presented was a 'partial' removable denture.
The insurance which I do have lead to a bad path: the 2 different oral surgeons my insurance sent me to were 3 times as expensive for what little it insured ... only the extraction and not the cutting, sectioning of the existing bridge. The oral surgeon I selected did not get paid by my insurance because my insurance covers only the extraction which would needed to have been performed by an oral surgeon on the list of oral surgeons provided by the insurance company which for me was United Concordia. The oral surgeon I selected this morning is not among those on the list of oral surgeons provided by the insurance company which for me was United Concordia.
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Post by jeffolie on Oct 29, 2013 12:16:50 GMT -6
I selected an oral surgeon, started the process to get 2 implants. I had the bridge section removed and an extraction today. The 2 implants installation procedure completed today ... my left side molars now work well
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