My implant bridge doesn’t fit, can it be removed?

Can my implant bridge be removed?

Yesterday I had my 3-tooth implant bridge placed on 2 implant posts. The implants are in place of my lower left first molar and second premolar, and the third tooth is my first premolar.

I’m not happy with the fit or the aesthetics but maybe I’m hoping for too much. The dentist adjusted it but wanted me to wear it before adjusting it further. The bridge was too long and the first premolar was shaved down so that it is flat where it meets the tooth in front of it. The chewing surfaces of the two implant teeth were ground down to adjust the bite and now looks like you can see the layers like a tree trunk, as if it were ground past the translucent ‘enamel’, and it looks like there are two silver fillings in the middle. The molar tooth feels abrupt and sharp on the edge by my tongue.

Also, I can see a space under the second premolar, and the post is visible both from the outside and the inside of my mouth. Food easily lodges underneath and in pockets between the first premolar and my canine tooth, where the first premolar was shaved off.

With all that said (whew), I don’t know that this can be modified properly or should/can this bridge be replaced? I don’t think I should pay top dollar for something that doesn’t fit or look right. Nor do I want to risk other issues that may arise.
– BK from Phoenix

Dear BK,
You’ve been very good at explaining what is going on with this. And while you didn’t state it explicitly, the implication of your introductory question is that this implant bridge has been cemented in your mouth.

It is not unusual for a bridge to need to be adjusted when it it placed. But the proper procedure is to adjust it BEFORE it is cemented – to make sure everything is okay with it FIRST, then cement it. And it sounds like there were an awful lot of adjustments here – a lot of grinding went on. Here is my assessment of your situation:

The spots that look like silver fillings are maybe where the porcelain had to be completely ground off the bridge in order to get it to fit your bite. Either the bite registration that was taken after your implant abutments were placed was off, or your teeth moved since then because a temporary bridge wasn’t placed. Whenever a bridge is done, or even a single crown, a temporary restoration needs to be placed or the teeth will drift. It only takes them two or three days to start to move.

And the roughness and sharpness you feel are also products of the large amount of adjustment that had to be made. This can be smoothed and polished, but with a bridge, it would have been better to have taken a new bite registration, placed a new temporary bridge, and had these problems fixed in the dental laboratory where they could fix these problems on a laboratory bench – a much easier place to work and get a first class result than in your mouth.

But the most serious problem is actually that you are catching food. This has the potential of causing serious problems down the road. It will easily lead to decay of your canine tooth and could cause inflammation and possibly infection around the implants.

It would not have been hard for the dentist to have temporarily cemented this bridge and let you try it out for a while. Then it would be easy to remove it and send it back to the lab if necessary. Now that it appears to have been cemented, however, it can still be removed. It will just have to be ground off and a new implant bridge can be started from scratch.

This blog is sponsored by Phoenix cosmetic dentist Dr. Arthur Chal.

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