Implant Supported Bridge

[Gellia]

Hi,
I'm all set to have my four top front teeth extracted and getting four implants. My regular dentist has told me that he will make a porcelain fused to low noble metal implant supported bridge for me. Is this what I want??
Doesn't PFM leave a gray line at the gum margin? Can anyone tell me what is the best implant supported bridge to have for front teeth? It seems he only does PFM. Any information would really be appreciated. I don't want to spend $5000 and hate this.
Thanks.

 

[Gordon]

I don't know enough to give you an informed answer, Dr Mike works with implant specialists and may be more help.
From what I do know, a good PFM needn't leave a dark line at the margin, at least the ones I fit don't. It's possible to get an all ceramic collar on the crown.

 

[Gellia]

Thanks for your reply.
When I expressed my concern about a gray line, my dentist just said he'd make sure the edges were well under the gum. I know my gum will recede over time so I am really concerned as it seems that low noble PFM is all he does and they seem so "flat" looking to me. I don't think his lab can do porcelain rims, but I'm not sure. He didn't offer them when I told him I didn't want the gray lines.
I thought I was getting four implants here so it would have the extra strength.
As these are my front teeth can you make a recommendation as to bridge materials you would use if it was yourself? I appreciate it.
Thank you.

 

[Raha]

When fitting an implant supported bridge the materials that can be used are:
-PFM bridge
- all ceramic reinforced bridge
- composite bridge reinforced by metal framework

our implant surgeon tends to use PFM because of
1- strength
2- great aesthetical results (thanks to the skilled technician used)

the type of bridge used depend on many factors:
1- what is best in the hands of the technician
2- bite forces
3- cost

If PFM bridges are done well, you should not be able to see the grey margins.

Hope this helps and keep us informed of the progress!

Best of Luck

Raha

 

[Gellia]

Thanks for your reply. I guess my biggest concern is that my dentist also did my husbands single implant crowns (he had 7) and I can see a heavy gray line around all of them already. His gum has receded a bit and he has only had them for about two years or so. They also look flat and dull in color and not very pretty for front teeth at all. You can tell they are fake. They look great for the back, but I really feel they would make me very unhappy for the front.
I also didn't want any7 metal in my mouth at all unless it was absolutely necessary.

If I'm getting four implants to replace the four teeth, do I really need the strength of the PFM?
Thank you so much.

 

[Raha]

Hi

all ceramic bridges reinforced with Zirconia or Procera bridges are still very strong and can look cosmetically good too.

Remember, the aesthetics of a crown/bridge also depends on the technicians used by the dentist. Each technician has different artistic skills and will work better with different materials compared to another technician.

With regards to your husband's gray line on the implant crown, recession around an implant crown can be due to:
1- not seeing a hygienist regularly
2- not maintaining meticulous oral hygiene regime
3- thin gums
4- inadequate bone around the implants
etc

no matter what type of bridge you have fitted, any of the above reasons can lead to recession causing the margin of a crown or bridge to be noticeable.

I'd recommend to speak to your dentist about your concerns.

Raha

 

[Gellia]

Thank you SO much for your reply.

My DH goes to the periodontist every three months, faithfully. He has meticulous oral care (brushing twice daily and flossing twice daily) and had bone grafts done with all his implants. The hygienist has told him the gray line is the tooth margin (it has a sharp edge) showing the gray metal base and not the implant neck.
That's exactly what I don't want. His are back molars so they don't show.

My dentist is a regular dentist, not a cosmetic dentist, and older fashioned. He hasn't changed or updated his techniques in 30 years. His lab is the same one he has always used. All they make are porcelain on low noble gray metal. I really feel the work they do is flat and opaque in appearance and not for my front top teeth. He also does not do oval pontic shaping in front but leaves black triangles around the teeth.
Your mentioning of zirconia or Procera is what I think I will have to look into.
It seems that if I'm going to the expense and pain (not to metnion the cost) of four implants with bone grafts and tissue regeneration for the four teeth for strength, an all porcelain bridge would be most esthetically pleasing and still meet all the strength requirements.
I guess I just have to find someone around me that does them.
I honestly don't want to end up looking worse than I'm starting. My natural teeth are not that bad at all, but I'm loosing them because of an accident and bone loss.
Thank you for the information you have given me. I really appreciate it.
Gellia