Maryland/sticky bridge replaced - disaster - help!

[Peaches626]

Hello again everyone. I was last here in 2022 after an accident left me missing a front tooth. I got excellent advice and support and really need some more of you gave it going spare

So I have a single false tooth on a winged/maryland bridge as one of my front two teeth. I knocked the bridge out accidentally on Thursday and went in to have it re-cemented today. The dentist was having difficulty reinserting and eventually ‘did the best she could’ but this has left me with a very crooked front tooth, much longer than the one next to it and than it was originally. Is there any way to have the false tooth reshaped along the bottom/at the corner to make it match the rest of my mouth without having it removed? I know when it was originally fitted in 2022 I wasn’t happy with the very square edges so the dentist sort of curved them by I presume sanding and buffing?

I’m so upset and can’t face this forever first pic now. Second pic last week

 

[Gordon]

I sympathise, that's pretty awful
Yes, it should be possible to improve on it a wee bit by reshaping the porcelain and re-polishing it, but not a lot, the trouble is you've got about 1mm of porcelain to play with so not much room for adjusting it.
I think I'd want to replace it altogether if I was your dentist.

 

[Peaches626]

@Gordon I’m so glad you’re still here… you were my guardian angel in 2022!

How much does it hurt to have it removed? I don’t understand why she couldn’t get it back in… the prosthetic wasn’t damaged and the gap is obviously the same! The only thing I can think is that she didn’t push it up into the gum far enough? It was placed much higher last time…

And in terms of fault, where do I stand? Now, I know when she asked if I was happy I agreed but that was based on how it looked with her holding it in my mouth and when I showed her the other picture in my post. I then didn’t see it again before she did the sticking parts. I really can’t afford a whole new bridge to be honest.

Plus she’d already been at it some time so my anxiety was through the roof.

This morning it is very tender in there and although it feels secure it is very sensitive and there is what I can only call a throbbing in the gum above the tooth.

I just know when I get in touch I’ll get the standard email about ‘we don’t cement until you’re happy’.

I’m so frightened and sad all over again.

 

[Gordon]

How much does it hurt to have it removed?

Shouldn't hurt at all. It'll be a bit scary though, needs a sharp tap in the right direction to break the cement.

How long had it been out for? If it was a few weeks then the teeth could've drifted out of place slightly.
From the photos, it looks like the bridge is slightly twisted forward. I'm amazed the dentist got it to stick like that, normally they're not very forgiving if you don't get the wing exactly into position.

I wouldn't have been happy sending you out like that and would probably redo the cementing job for nothing, hopefully your dentist feels the same.

 

[Peaches626]

A sharp tap? Oh god that sounds awful. Will I need anaesthetic?

It’d been out one day.

 

[Gordon]

You have to break the cement, otherwise it's down to cutting the bridge off and destroying it, sorry. You won't need anaesthetic, but you can ask for some if it would help.

One day wouldn't cause a problem with drifting then.

 

[Peaches626]

Does it usually come off quite easily? I’d assumed it would be drilled off I guess. If they tap too hard won’t it loosen the tooth?

I’m literally terrified….

 

[Gordon]

I had a profoundly learning disabled patient once (it's important to note that he wasn't able to speak) for whom I made a rather nice Maryland to replace his front tooth. It did well for about a year then failed. I put it back in, then it failed again a week later. I made a new one. That lasted about 3 days.
His mum caught him putting the cable for his earphones in under the bridge and pulling it out.
I guess he didn't like wearing it after all and couldn't tell me.

 

[Gordon]

They come off quite easily, you're not talking about hitting the tooth with a hammer or something! No it won't damage the supporting tooth.
If you really don't fancy it then get them to cut it off and make you a new one.

 

[Peaches626]

How would it be cut off? The cement would still need to come off? What is it hit with (if not a hammer)?

If it doesn’t hurt, why would anaesthetic help?

I’m so scared of all of it.

 

[Gordon]

With a handpiece, a bit like having a filling. The cement would be removed by the handpiece. Usually tapped with a little sliding weight thing. You hook it onto the bridge and let the little weight slide down the handle.
I said you didn't need anaesthetic, but if you were worried about potential pain (there really shouldn't be any) then you could have some.

 

[Peaches626]

Oh good grief that sounds terrifying…does the little weight bang onto the tooth that the wing is attached to? Does it usually take more than one ‘go’?

I haven’t had any reply to my email yet though.

 

[Gordon]

It bangs against the bridge not the supporting tooth.

 

[Peaches626]

@Gordon i have been back to the dentist and she has corrected the error by shaping and polishing. I am much much happier. She even managed to flatten the bulbous top bit which has never been offered to me before and looks and feels better. She has asked me to live with it for a week then come back for any tweaks if I feel I want anything else adjusting. What do you think?

Pic 1 is original fit, Pic 2 after disastrous refit and Pic 3 is today

 

[Gordon]

That's a lot better, you must be pleased!

 

[Peaches626]

Yes super pleased (and very relieved!).

In terms of tweaks I can’t see anything glaring… the length and edges look even? From your dentist’s eye us there anything else you’d do if I was in your chair?

 

[Gordon]

No.

There's a danger of messing things right up (going through the porcelain into the underlying gold shell for instance) if you try to get it "perfect", real teeth aren't "perfect" in any case

 

[Peaches626]

@Gordon yeah that’s my thinking too. I’m pretty happy with the improvement and don’t want to bugger it up