Dental advice - Dental bridge replacement??

Hi there


I have had a dental bridge for 27yrs which was done in South Africa - unfortunately one of the front teeth at top near the gum is losing porcelain and shows a little black mark when I smile.





Would I need a complete bridge renewal (done privately) or could this be fixed (say a veneer or something??). Expert advice will be most welcome!

Dental advice - Dental bridge replacement??
More than likely a bridge that is 27 yrs old should be replaced. The bridge margins should be checked for possible decay under that bridge and opened margins which can be a plaque trap. If you are seeing a black line at the edge that is usually a thin metal collar that was meant to be subgingival at one time(under the gum) and your gums have either receded or there is decay present.


Because the bridge had been in your mouth for 27 years to try a repair would be just about crazy, okay insane. Any repairs that would hold would meaning removing the bridge in one piece and re-firing it, all other repairs do not hold worth the 2 cent paid for them.


When Porcelain is originally fused to metal it is place in a oven under vacuum pressure and when a portion of that porcelain breaks off, over time, there is NO GUARANTEE that the adjacent porcelain will not pop off as well.


Your best bet is to have the bridge checked and if possible remade.


If finances are a concern, consider having a partial made to replace the teeth missing under the bridge, and if possible, they may be able to salvage the abutment crowns, but only a dentist can make that determination after a complete examination.


***There is something called "Standard of Care" which all dentists are held to. When we got into this business our goal was to make the lives of the people we treat as best as we possibly can, looking at all options, giving as many options as we can, but never detering from doing our best for any other possible gain or motive. We also don't slouch and give substandard of care because it is easier. In a court of law this can found negligent and of poor standards possibly threatening a person's life. We could ultimately be sued and stripped of our dental license for such practices. A bridge life expectance is 10 years. Some can exceed that limit, but when they start to break down we are obligated to do the very best and giving a PERMANENT restoration, not a quick fix. Being that this bridge is also 27 years old, it could be the old gold to acrylic as well and any practicing dentist who values his license or his ability or most of all, that patient's health would not repair this either. Get yourself in with a real dentist and have it examined fully.***
Reply:expert advice and lots of money
Reply:Some dentists will say you need a whole new bridge. As long as the bridge is sound, you can get that area fixed. Not every dentist knows how, nor has the equipment to correct this.


Procedure after verification of soundness:


Smooth off jagged edges of porcelain


Sandblast metal and porcelain*


Treat porcelain with porcelain repair gel


Treat metal with "metaltite"*


Put silane on the porcelain


Cover all areas with bonding agent


Apply opaquer/masking agent over black/metal*


Put filling material over all of it and polish


The starred areas are some of the materrials the dentists may not have. Call around to find out. I do these repairs all of the time


Good Luck!
Reply:PS to Dr. Helen's response: A shade matching the original bridge shade is selected....
Reply:A twenty seven year old bridge has been a good one, but it may have seen its better days. Porcelain chipping off is a common problem, it happens even with the newer bridges. It leaves only two choices, repair or replace.





The above responder is correct in the fact that a filling can be placed on this chipped porcelain area, although it will not “completely” hide the black marking of the underlying metal of the bridge that is showing through, nor will this bridge ever be as aesthetically pleasing as it once was but it will offer some coverage so it won't be as noticeable. This is a good option to “repair rather than a replace” though.





I would also be hesitant to remove the bridge, if the teeth and bridge are sound and this chipped area isn’t going to present any problem, other than its appearance. The rough porcelain can be easily smoothed giving the patient time to consider their options or do nothing at all to the bridge. Some dentist would prefer to remove the bridge and re-make it; just to be sure the teeth under the bridge are sound, since we can’t see them through the metal of the bridge with an x ray. I can't think of any repair or dental work for that matter, that would cost 2 cents, don't even consider repairing the bridge to be "insane or crazy." Some of the "best dental work" to be found, is the "oldest" work seen today. Helen DDS has given the most appropriate answer to your question.





So the options of “repair or replace” are up to the patient, if the bridge is sound. The appearance vs. the cost of replacement is usually the deciding factor for most patients.








Additional information: Someone advised that the bridge be removed and replace with a removable partial, if finances are an issue. It probably wounldn't be practical to do that, the abutment teeth under the bridge in question would "require crowns," which can be expensive along with the added expense of a "removable partial." Depending on the type of partial selected, it may be "nearly as costly" to take that route not to mention "less acceptable" since it is removable. Having the fixed bridge is the closest thing to natural teeth, with the exception of implants.
Reply:Hi Tina..





If the area is small I'd fix this.


But remember nothing we can give u is ever as satisfactory *** your own teeth.


27 is very good and great value.


Crowns usually last 10ish years despite what you're told they're liable to crack after this time.





You can get this unit of the bridge repaired perhaps but be aware that another bit may go soon..its 27years old.





The smaller the gap the easire it'll be to fix but I'd really need to see it to know.





How big is the bridge?How many units?How many teeth were lost there?





Tell your dentist u want to repair it,u can always think about a new one in the future.





Paul
Reply:i am a dental nurse and have never known a bridge, especailly of that age to be repaired, the margains around the bridge begin to show after time usually due to gum recession. i think you have done very well for it too last 27 years but do think a new bridge would be recommended now also removing it to be able to send it away to a lab for repairs will probably result in damage to the exsisting bridge. all the best.
Reply:Dental composite filling material will not bond well with the bridge. If the bridge can be removed without damaging it, it can be sent to a lab where they can repair the damage. The difficulty will be in removing it. Not such a bad thing when you think that it was put in there to stay!





Ask your dentist, only they will know how your specific bridge can be dealt with. Good luck.

Skin